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Abdominal Intraluminal Gossypiboma: Demographics, Predictors of Intraluminal Site, Diagnostic and Treatment Measures

Authors Obeidat KA, Aleshawi AJ, Alebbini MM, Bani Yasin SN

Received 26 October 2019

Accepted for publication 17 February 2020

Published 27 February 2020 Volume 2020:13 Pages 65—72


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Prof. Dr. Everson L.A. Artifon

Khaled A Obeidat,1 Abdelwahab J Aleshawi,2 Mohanad M Alebbini,2 Saja N Bani Yasin2

1Department of General Surgery and Urology, Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan; 2Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan

Correspondence: Khaled A Obeidat
Department of General Surgery and Urology, Faculty of Medicine, Jordan University of Science and Technology, P. O. Box: 3030, Irbid 22110, Jordan
Tel +962797707397
Fax +962 2 7201064

Objective: Intra-abdominal gossypiboma may present with variable clinical presentations. The clinical picture that the patient presents with depends on the site of the retained gauze in the abdomen, with transmural migration leading to intraabdominal gauze being a rare occurrence. We systemically analyze articles and reports related to the transmural migration of gossypiboma. In addition, we report a case of ileal transmigration of gossypiboma in a 53-year-old female.
Methods: A systematic literature review was conducted using Embase and Medline for articles pertaining to transmural migration of gossypiboma. Three of the authors extracted the data from the selected studies that relate to the topic. All articles included were in English language and published in peer-reviewed journals. This study was conducted according to the guidelines set out by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
Results: A total of 93 cases of intraluminal gossypiboma were found in the literature. The mean age of the patients was 40.4 years and females (77.7%) were affected more than males. The obstetric and gynecologic surgeries were the leading causative operation (41.5%). However, cholecystectomy is the most common single surgery associated with intraluminal gossypiboma. The mean time from the causative operation was 35.16 months. Most patients presented as intestinal obstruction. CT scan was the most sensitive tool to detect any non-specific finding while the endoscopic interventions were the most specific. Ileum is the most common site for intraluminal for migration. Intra-gastric location is related mostly to the hepato-biliary operations. Laparotomy with segmental resection provides a primary treatment and cure.
Conclusion: Clinicians should keep the possibility of gossypiboma, including intraluminal, in their mind when a patient presents with abdominal pain, signs of infection, intestinal obstruction, or a palpable mass any time after abdominal surgery. Measures for prevention and education are the most useful tool to avoid such complications.

Keywords: gossypiboma, transmural migration, intra-abdominal, retained surgical sponge, surgical complication, textiloma

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