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Retained surgical sponge after laparotomy : discussion about 8 cases

Only rare cases of retained sponge after abdominal surgery or textiloma or gossipyboma have been published. Aim. Our objective was to report cases of textiloma after laparotomy. Patients and method. This is a retrospective study (1995-2006) that compiled 8 files of patients presenting textiloma after 6792 abdominal surgeries. The frequency of textiloma was 0.12%. The average age of our patients was 27.8 years. There were 6 men and 2 women. Five patients were operated in emergency and 3 were within scheduled surgery. Initial indications for scheduled surgery were: 1 case of hydatid cyst of the liver, 1 case of pheochromocytoma and 1 case of adenocarcinoma of the rectum. Among emergency cases, 2 were appendicular abscesses, 1 case of volvulus of the pelvic colon, 1 case of ruptured ectopic preg-nancy and 1 case of iatrogenic rectal fistula. Intraoperative difficulties in hemostasis have been reported in 3 patients. Indica-tions for reoperation were postoperative peritonitis in 1 case, hemoperitoneum in 1 case, a mass of the left hypochondrium in 1 case, a purulent discharge through the opening drain port in 2 cases, a mass of the right iliac fossa in 2 cases and an incidental finding in 1 case. The delay for revision surgery ranged from 3 days to 6 years. The surgical procedure was a simple removal of textiloma in 7 cases and in 1 case ileocecal resection associated with an ileostomy and a colostomy was necessary. Mortality rate was 25% (2 cases). Conclusion. Retained surgical sponge is an incident that may occur after any laparotomy especially if done in emergency. The best treatment is prevention, which recommends a vigilance of the entire surgical team.

Auteur(s) : Dieng M, Sanoussi Y, Toure AO, Ka I, Cissé M, Konaté I, Ka O, Touré CT
Pages : 79-82
Année de publication : 2012
Revue : Surgical Chronicals
N° de volume : volume 2, numéro 17
Type : Article
Mise en ligne par : KA Ousmane