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Saturday, 10 May 2014

CASE 253: GOSSYPIBOMA (TEXTILOMA) POST CAESAREAN SECTION for a YEAR, Pham Hong Dong,M.D; Nguyen Duc Duy Linh,M.D; Phu Van Tuot,M.D; Nguyen Ngoc Xuan Giang,M.D., MEDIC Binh An Kien Giang Hospital

A 26 year-old female patient who had complained mild pain at her pubic region  presented lower abdominal pain a month prior. She  overwent a caesarean section a year ago for delivery her child.
Ultrasound findings:A cystic mass (about 83x46 mm) containing distinct internal hyperechoic wavy, striped structures.    

CT Scan abdomen: A mass of 11 x 9 cm with thicken enhancing walls was seen in pelvis.

But diagnosis of gossypiboma was made and at laparotomy: a surgical sponge (18x22 cm) with adjacent inflammatory tissue and pus were removed successfully.

A diagnosis of gossipiboma pre-op seems to be very difficult that always need skill and experience. Because of  imaging findings of gossypiboma are nonspecific and complexe so the right diagnosis in pre-op is still acchived about 1/3 of cases in literature.
But whenever an unknown mass into abdomen with exist surgical scare that should dissolve it may be a gossypiboma or not.

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