Intestinal Obstruction due to Complete Transmural Migration of a Retained Surgical Sponge into the Intestine
A 56-year-old woman with a history of gynecological surgery for cervical cancer 18 years previously was referred to our hospital for colicky abdominal pain, nausea and vomiting. Intestinal obstruction was diagnosed by contrast-enhanced computed tomography (CT) which showed dilation of the small inte...
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2012-12-01
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Series: | Case Reports in Gastroenterology |
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doaj-c09854f955144d2b84efa8003a6bfac62020-11-25T00:09:28ZengKarger PublishersCase Reports in Gastroenterology1662-06312012-12-016375475910.1159/000346285346285Intestinal Obstruction due to Complete Transmural Migration of a Retained Surgical Sponge into the IntestineTakashi KatoKoji YamaguchiKoji KinoshitaKiyotaka SasakiHidetoshi KagayaTakashi MeguroTakayuki MoritaToshiyuki TakahashiNagara TamakiShoichi HoritaA 56-year-old woman with a history of gynecological surgery for cervical cancer 18 years previously was referred to our hospital for colicky abdominal pain, nausea and vomiting. Intestinal obstruction was diagnosed by contrast-enhanced computed tomography (CT) which showed dilation of the small intestine and suggested obstruction in the terminal ileum. In addition, CT showed a thick-walled cavitary lesion communicating with the proximal jejunum. 18F-fluorodeoxyglucose positron emission tomography showed abnormal uptake at the same location as the cavitary lesion revealed by CT. The patient underwent laparotomy for the ileus and resection of the cavitary lesion. At laparotomy, we found a retained surgical sponge in the ileum 60 cm from the ileocecal valve. The cavitary tumor had two fistulae communicating with the proximal jejunum. The tumor was resected en bloc together with the transverse colon, part of the jejunum and the duodenum. Microscopic examination revealed fibrous encapsulation and foreign body giant cell reaction. Since a retained surgical sponge without radiopaque markers is extremely difficult to diagnose, retained surgical sponge should be considered in the differential diagnosis of intestinal obstruction in patients who have undergone previous abdominal surgery.http://www.karger.com/Article/FullText/346285Retained surgical spongeGossypibomaTextilomaIntestinal obstructionIleus |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Takashi Kato Koji Yamaguchi Koji Kinoshita Kiyotaka Sasaki Hidetoshi Kagaya Takashi Meguro Takayuki Morita Toshiyuki Takahashi Nagara Tamaki Shoichi Horita |
spellingShingle |
Takashi Kato Koji Yamaguchi Koji Kinoshita Kiyotaka Sasaki Hidetoshi Kagaya Takashi Meguro Takayuki Morita Toshiyuki Takahashi Nagara Tamaki Shoichi Horita Intestinal Obstruction due to Complete Transmural Migration of a Retained Surgical Sponge into the Intestine Case Reports in Gastroenterology Retained surgical sponge Gossypiboma Textiloma Intestinal obstruction Ileus |
author_facet |
Takashi Kato Koji Yamaguchi Koji Kinoshita Kiyotaka Sasaki Hidetoshi Kagaya Takashi Meguro Takayuki Morita Toshiyuki Takahashi Nagara Tamaki Shoichi Horita |
author_sort |
Takashi Kato |
title |
Intestinal Obstruction due to Complete Transmural Migration of a Retained Surgical Sponge into the Intestine |
title_short |
Intestinal Obstruction due to Complete Transmural Migration of a Retained Surgical Sponge into the Intestine |
title_full |
Intestinal Obstruction due to Complete Transmural Migration of a Retained Surgical Sponge into the Intestine |
title_fullStr |
Intestinal Obstruction due to Complete Transmural Migration of a Retained Surgical Sponge into the Intestine |
title_full_unstemmed |
Intestinal Obstruction due to Complete Transmural Migration of a Retained Surgical Sponge into the Intestine |
title_sort |
intestinal obstruction due to complete transmural migration of a retained surgical sponge into the intestine |
publisher |
Karger Publishers |
series |
Case Reports in Gastroenterology |
issn |
1662-0631 |
publishDate |
2012-12-01 |
description |
A 56-year-old woman with a history of gynecological surgery for cervical cancer 18 years previously was referred to our hospital for colicky abdominal pain, nausea and vomiting. Intestinal obstruction was diagnosed by contrast-enhanced computed tomography (CT) which showed dilation of the small intestine and suggested obstruction in the terminal ileum. In addition, CT showed a thick-walled cavitary lesion communicating with the proximal jejunum. 18F-fluorodeoxyglucose positron emission tomography showed abnormal uptake at the same location as the cavitary lesion revealed by CT. The patient underwent laparotomy for the ileus and resection of the cavitary lesion. At laparotomy, we found a retained surgical sponge in the ileum 60 cm from the ileocecal valve. The cavitary tumor had two fistulae communicating with the proximal jejunum. The tumor was resected en bloc together with the transverse colon, part of the jejunum and the duodenum. Microscopic examination revealed fibrous encapsulation and foreign body giant cell reaction. Since a retained surgical sponge without radiopaque markers is extremely difficult to diagnose, retained surgical sponge should be considered in the differential diagnosis of intestinal obstruction in patients who have undergone previous abdominal surgery. |
topic |
Retained surgical sponge Gossypiboma Textiloma Intestinal obstruction Ileus |
url |
http://www.karger.com/Article/FullText/346285 |
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