Intravesical surgical gauze from previous surgery complicating management of chronic myeloid leukaemia – a case report

Abstract

Surgical instruments left in the human body after procedures are not uncommon. In this report, we describe the case of surgical gauze left in the abdominal cavity, most probably in the urinary bladder producing massive haematuria 13 years after. This occurred after the patient had received a combination cytotoxic chemotherapy including cyclophosphamide for advanced phase chronic myeloid leukemia. The haematuria was initially assumed to be due to metabolites of cyclophosphamide until gauze was noticed protruding out of her urethra. Following careful removal of the gauze and bladder washout with evacuation of the clots, the haematuria subsequently stopped. This report reinforces the need for surgeons to be extremely vigilant and to be sure that surgical instruments/gauzes used are complete after procedures. It also highlights the need for proper history taking and adequate evaluation of patients.

Key words: Foreign body, haemorrhagic cystitis, cyclophosphamide