A Relook at Gossypibomas with a Focus on Imaging Findings: A Case Report

Background: Retained surgical sponges, also known as gossypibomas or textilomas are seldom reported due to medico-legal implications, especially for the surgical team. Some are discovered in the early post-operative period, while others are discovered many years later with varied manifestations and complications as well as non-specific imaging findings.

Presentation of Case: We report a case of a 79-year-old lady with colon carcinoma who had a colostomy and multiple previous surgeries. A retained sponge was incidentally found on CT scan done for radiological evaluation prior to stoma reversal, confirmed on conventional radiography and MRI. The sponge was removed with small bowel resection and anastomosis during the stoma reversal surgery. Unfortunately, she had a stormy post-surgical period and succumbed 3 months later.

Discussion: Imaging findings depend on the time of presentation, presence of radiopaque marker, type of reaction elicited by the retained foreign body as well as its complications. In the early post-operative period, they may mimic hemostatic agents, hematoma and abscesses while in chronic cases, may mimic tumours, both malignant and benign.

Conclusion: Awareness of the varied imaging findings and early detection of retained foreign bodies are essential, requiring a high index of suspicion in patients who have a history of previous surgery.