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CASE REPORT
Year : 2018  |  Volume : 35  |  Issue : 3  |  Page : 447-450

Textiloma discovered 22 years after splenectomy: a case report


Department of General Surgery Mansoura, Faculty Medicine, Mansoura University, Egypt

Correspondence Address:
Dr. Hesham Elgendy
8th DDep of Surgery, 2nd Floor, Main Building, Mansoura University Hospital, Elgomhoryia Strret, Mansoura, 35516, 35511
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bmfj.bmfj_28_16

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Background Retained foreign body after laparotomy is not uncommon. Surgical sponge is considered the most common retained foreign body and this is called textilomas or gossypibomas. Retained sponge induces a severe foreign body reaction, which usually leads to serious complications. Although the complications induced by retained foreign bodies are known, only a few cases can be found in the literature because of medicolegal aspects. Case presentation This case report focuses on a 50-year-old male farmer with a history of splenectomy, who presented to us with a picture of acute small bowel obstruction and toxemic shock. Laboratory investigations indicated marked leukocytosis, and elevated serum bilirubin and creatinine levels. Computedtomography scan of the abdomen showed a heterogeneous round object in the left upper quadrant of the abdomen. Upon exploratory laparotomy, a textiloma was discovered with intestinal loops coiled round it. Resection of the diseased bowel loops was performed with ileostomy. The patient was admitted to the ICU as his condition continued to deteriorate; he developed hepatorenal syndrome, followed by hepatic encephalopathy and died. Conclusion Gossypiboma is not a straightforward diagnosis; accidentally retained sponges are not usually suspected clinically, but subsequently recognized on computed tomography imaging studies. The delay in the detection of RFO leads to serious complications that may cost the patient his/her life, which is why it must be suspected in any patient with a history of operative intervention.


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