Background: Surgical sponges are used in almost all surgeries in Liberia and around the world. They sometimes may inadvertently be left in the body following a surgery and are then referred to as gossypibomas or textiloma. Their presence can result in significant morbidity and even mortality for the patient, and unpleasant medicolegal consequences for the surgeon. This case is the first to be reported from Liberia. Case Presentation: A 43-year-old para 3, alive 3 Liberian lady, presented in our emergency room in acute urinary retention. Plain kidney, ureter and bladder X-rays showed an amorphous calcified object within the urinary bladder. Abdominal ultrasound scan revealed 7 cm × 5 cm bladder stone. She underwent open cystolithotomy, and a partially calcified gauze swab was recovered from the bladder. The patient was discharged after a smooth post-operative period and follow-up cystoscopy showed no intravesical abnormality. Conclusion: Gossypiboma or textiloma is apparently very rare in Liberia, as there is no mention of its occurrence in academic literature from Liberia. The presence of any foreign body in the bladder can potentiate the formation of a calculus. Radiological findings are variable and non-specific, thus increasing the risk of a missed diagnosis. The morbidity associated with this condition and the possibility of medico-legal liability make prevention of this condition imperative.
References
[1]
Sharma, G. and Bigelow, J. (2014) Retained Foreign Bodies: A Serious Threat in the Indian Operation Room. Annals of Medical and Health Sciences Research, 4, 30-37. https://doi.org/10.4103/2141-9248.126605
[2]
Hajji, F. and Ameur, A. (2015) Gossypiboma. Pan African Medical Journal, 20, Article No. 332. https://doi.org/10.11604/pamj.2015.20.332.6609
[3]
Gümüş, M., Gümüş, H., Kapan, M., Önder, A., Tekbaş, G. and Baç, B. (2012) A Serious Medicolegal Problem after Surgery: Gossypiboma. American Journal of Forensic Medicine & Pathology, 33, 54-57. https://doi.org/10.1097/paf.0b013e31821c09fe
[4]
Varlas, V.N., Bors, R.G., Mastalier, B., Balescu, I., Bacalbasa, N. and Cirstoiu, M. (2023) Gossypiboma, the Hidden Enemy of an Emergency Cesarean Hysterectomy—Case Report and Review of the Literature. Journal of Clinical Medicine, 12, Article No. 5353. https://doi.org/10.3390/jcm12165353
[5]
Bairwa, B.L. (2021) Gossypiboma—An Unusual Cause of Surgical Abdomen and Surgeon’s Nightmare: A Rare Case Report. International Journal of Surgery Case Reports, 80, Article ID: 105521. https://doi.org/10.1016/j.ijscr.2021.01.015
[6]
Silva, S.M.E. and Sousa, J.D..B (2013) Gossipiboma após operação abdominal é situação clínica desafiadora e sério problema médico legal. ABCD. Arquivos Brasileiros de CirurgiaDigestiva (São Paulo), 26, 140-143. https://doi.org/10.1590/s0102-67202013000200015
[7]
Biswas, R.S., Ganguly, S., Saha, M.L., Saha, S., Mukherjee, S. and Ayaz, A. (2012) Gossypiboma and Surgeon-Current Medicolegal Aspect—A Review. Indian Journal of Surgery, 74, 318-322. https://doi.org/10.1007/s12262-012-0446-3
[8]
Gawande, A.A., Studdert, D.M., Orav, E.J., Brennan, T.A. and Zinner, M.J. (2003) Risk Factors for Retained Instruments and Sponges after Surgery. New England Journal of Medicine, 348, 229-235. https://doi.org/10.1056/nejmsa021721
[9]
Wan, Y.L., Ko, S.F., Ng, K.K., Cheung, Y.C., Lui, K.W. and Wong, H.F. (2004) Role of CT-Guided Core Needle Biopsy in the Diagnosis of a Gossypiboma: Case Report. Abdominal Imaging, 29, 713-715. https://doi.org/10.1007/s00261-004-0172-9
[10]
Kiernan, F., Joyce, M., Byrnes, C.K., O’Grady, H., Keane, F.B.V. and Neary, P. (2008) Gossypiboma: A Case Report and Review of the Literature. Irish Journal of Medical Science, 177, 389-391. https://doi.org/10.1007/s11845-008-0197-0
[11]
Garg, M. and Aggarwal, A.D. (2010) A Review of Medico Legal Consequences of Gossypiboma. Journal of Indian Academy of Forensic Medicine, 32, 358-361.
[12]
Sharma, G. and Bigelow, J. (2014) Retained Foreign Bodies: A Serious Threat in the Indian Operation Room. Annals of Medical and Health Sciences Research, 4, 30.
[13]
Asuquo, M., Ogbu, N., Udosen, J., Ekpo, R., Agbor, C., Ozinko, M., et al. (2010) Acute Abdomen from Gossypiboma: A Case Series and Review of Literature. Nigerian Journal of Surgical Research, 8, 174-176. https://doi.org/10.4314/njsr.v8i3-4.54901
[14]
Bani-Hani, K.E., Gharaibeh, K.A. and Yagha, R.J. (2005) Retained Surgical Sponges (Gossypiboma). Asian Journal of Surgery, 28, 109-115. https://doi.org/10.1016/s1015-9584(09)60273-6
[15]
Iwase, T., Ozawa, T., Koyama, A., Satake, K., Tauchi, R. and Ohno, Y. (2007) Gossypiboma (Foreign Body Granuloma) Mimicking a Soft Tissue Tumor with Hip Hemiarthroplasty. Journal of Orthopaedic Science, 12, 497-501. https://doi.org/10.1007/s00776-007-1150-1
[16]
Pierson, M.A. (1995) Patient and Environmental Safety. In: Meeker, M. and Rothrock, J., Eds., Alexander’s Care of the Patient in Surgery, 10th Edition, Mosby-Yearbook, 19-34.
[17]
Vento, J.A., Karak, P.K. and Henken, E.M. (2006) Gossypiboma as an Incidentaloma. Clinical Nuclear Medicine, 31, 176-177. https://doi.org/10.1097/01.rlu.0000200923.24657.38
[18]
Muhammed, A., Ahmad, B., Hafeez, A., Hussaini, M. and Hycinth, M. (2012) Gossypiboma in the Scrotum with Unusual Cutaneous Manifestations. Archives of International Surgery, 2, 33-36. https://doi.org/10.4103/2278-9596.101270
[19]
Kim, C.K., Park, B.K. and Ha, H. (2007) Gossypiboma in Abdomen and Pelvis: MRI Findings in Four Patients. American Journal of Roentgenology, 189, 814-817. https://doi.org/10.2214/ajr.07.2323