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Annals of African Surgery

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Gossypiboma of the Abdomen and Pelvis; A Recurring Error

Gilbert Maranya, Heltam Maganga, Bernard Mwero

Abstract


Introduction: Gossypiboma is a retained surgical sponge commonly in the abdomen and pelvis. Risk factors include emergency and prolonged surgery. Attendant complications are: visceral obstruction, perforation, sepsis, fistulae and diagnostic dilemmas. The objective of this write up is to report the occurrence of gossypiboma and recommend corrective measures.

Methods: A retrospective audit undertaken at two hospitals in the Coast region of Kenya between 2008 and 2016 involved 11 patients.

Results: A female preponderance of 73% was observed. The mean age was 32 years. Emergency surgery accounted for 73% of the patients; with caesarian section dominating. Most patients were operated upon; while in one patient with uterine cervical tear and episiotomy, the sponge was extruded spontaneously per vaginum. One caesarian section patient had two sponges. In another two caesarian section patients, the sponges had no radiopaque marker. Mortality occurred in 3 (27%) patients.

Conclusion: The incidence of gossypiboma can be minimized by proper gauze and instrument management intraoperatvely. Change of operating personnel during surgery is discouraged.

Key words: Gossypiboma, Retained surgical sponges, Textilloma




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