Скачать или смотреть Ultrasound Video showing a rare case of Gossypiboma and “retained surgical items” (RSI).

This video shows a rare case of Gossypiboma and “retained surgical items” (RSI).
Gossypiboma and “retained surgical items” (RSI)

Gossypiboma, textiloma or more broadly “retained surgical items” (RSI) is the technical term. The symptoms of gossypiboma are usually nonspecific and may appear years after surgery.
Intraoperative ultrasound is cost-effective in localizing and helps in retrieving lost surgical items.
The most common cause of gossypiboma is the retained surgical sponge. The patient is taken up for sonography which can reveal a linear echogenic area having a strong posterior acoustic shadowing.
Ultrasonography allows the identification of practically all types of gossypibomas, including imaging of retained surgical sponges in the abdomen and pelvis.
With the introduction of a newer and broader term “retained surgical items” (RSI), additional materials such as needles, broken instruments, irrigation sets, and rubber materials have been included in the conventional list.
With the advent of newer imaging modalities retained surgical items are now easily diagnosed by their characteristic imaging appearances. A combination of complementary imaging modalities helps to arrive at the diagnosis of this relatively rare complication. Factors contributing to their imaging features include the timing of diagnosis and imaging, presence of secondary infection, communication of the retained item with hollow viscus or external skin wound, and type of imaging modality used. A high index of suspicion is necessary for diagnosis before labeling it as a retained surgical item. In parallel with recent advances in surgery, it is essential that there is increasing awareness among radiologists regarding the newer types of retained surgical items.
The term gossypiboma is derived from the Latin word “Gossypium” meaning cotton wool, the suffix -oma meaning mass. Other terms used are “textiloma,” “gauzoma,” “muslinoma.” A suitable example of a gossypiboma would be a mass-like reaction to surgical sponges that are accidentally left inside the patient during surgery.
Symptoms of Gossypiboma
Gossypiboma may present early with pain with or without lump formation or may remain asymptomatic for a long time with only vague symptoms. Patients may present with abdominal mass or subacute intestinal obstruction. Patients may rarely also present with fistula, perforation, or even extrusion per anus.