Chronically retained gauze (gossypiboma) resembling a mature cystic teratoma after Cesarean delivery: a case report

剖宫产后慢性残留纱布(纱布瘤)类似成熟囊性畸胎瘤:病例报告

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Abstract

BACKGROUND: A foreign body left behind during an operation is a medico-legal issue. It is an infrequent but avoidable surgical complication, which must be kept in mind in any postoperative patient who presents with pain, infection, or palpable mass. The author presents a rare case of chronic gossypiboma following a Cesarean delivery in a 40-year-old woman, who was a Para III patient from Western Ethiopia. She had been experiencing dull, aching pain since her previous Cesarean section four years prior. To address her complaints, she visited multiple health facilities where she was prescribed pain relief medications and antibiotics. The patient was eventually taken to the operating room with a preliminary diagnosis of a mature cystic teratoma. However, during laparotomy, surgical gauze was discovered and successfully removed. CONCLUSION: In patients who have previously undergone surgery for obstetric or other gynecological procedures and present with vague abdominal complaints, it is important to consider the possibility of a chronic gossypiboma mimicking a mass of unknown origin. Following established surgical protocols and implementing new preventive measures, such as using tagged gauze/ radio-opaque markers, and ongoing staff training could help reduce or prevent the occurrence gossypiboma. Additionally, the author advises performing delicate surgical procedures to remove retained gauze to prevent bleeding and tissue damage. The gauze should be gently lifted, and the wound must be examined for any damage.

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