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DOI: 10.1055/s-0045-1810410
Beyond the Spongiform Pattern of Gossypiboma: How a Radiopaque Marker Solved the Mystery of a Retained Sponge
Abstract
Gossypiboma, a retained surgical foreign body, is a rare but serious complication with variable clinical and radiological features, posing diagnostic challenges. This case report describes a 55-year-old female with a history of total abdominal hysterectomy and incisional hernioplasty, presenting with a 6-month history of insidious abdominal pain and a palpable right iliac fossa mass. Initial ultrasound suggested a mesenteric dermoid, but her surgical history raised suspicion of gossypiboma. Computed tomography revealed a nonenhancing hypodense lesion with a curvilinear high-density structure (average attenuation of 1200 HU) within causing streak artifacts, characteristic of a radiopaque surgical sponge marker, confirming the diagnosis. Exploratory laparotomy identified an encapsulated surgical mop with dense adhesions, necessitating adhesiolysis, appendectomy, and ileal resection. The postoperative course was uneventful. This case highlights the importance of considering gossypiboma in patients with prior surgery, even without classic imaging features, and underscores the critical role of radiopaque markers in diagnosis.
Publication History
Article published online:
30 July 2025
© 2025. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Van der Weiden RM. A foreign body (gossypiboma) in pregnancy: first report of a case. Gynecol Surg 2007; 4 (01) 61
- 2 Modrzejewski A, Kaźmierczak KM, Kowalik K, Grochal I. Surgical items retained in the abdominal cavity in diagnostic imaging tests: a series of 10 cases and literature review. Pol J Radiol 2023; 88: e264-e269
- 3 Pole G, Thomas B. A pictorial review of the many faces of gossypiboma–observations in 6 cases. Pol J Radiol 2017; 82: 418-421
- 4 Lu YY, Cheung YC, Ko SF, Ng SH. Calcified reticulate rind sign: a characteristic feature of gossypiboma on computed tomography. World J Gastroenterol 2005; 11 (31) 4927-4929
- 5 Shyung LR, Chang WH, Lin SC, Shih SC, Kao CR, Chou SY. Report of gossypiboma from the standpoint in medicine and law. World J Gastroenterol 2005; 11 (08) 1248-1249
- 6 O'Connor AR, Coakley FV, Meng MV, Eberhardt SC. Imaging of retained surgical sponges in the abdomen and pelvis. AJR Am J Roentgenol 2003; 180 (02) 481-489
- 7 Puri A, Anchan C, Jambhekar NA, Agarwal MG, Badwe RA. Recurrent gossypiboma in the thigh. Skeletal Radiol 2007; 36 (Suppl. 01) S95-S100
- 8 Lauwers PR, Van Hee RH. Intraperitoneal gossypibomas: the need to count sponges. World J Surg 2000; 24 (05) 521-527
- 9 Aminian A. Gossypiboma: a case report. Cases J 2008; 1 (01) 220