GOSSYPIBOMA WITH INTESTINAL NECROSIS AFTER CESAREAN SECTION: TWO CASES FROM PAKISTAN

Muhammad Usman; Naeem Sarwar; Shahzeena Kaleem; Tayyaba Hamid; Asghar Ali; Khalil-ur-Rehman

doi:10.51642/ppmj.v36i03.775

Muhammad Usman Arif Memorial Teaching hospital Lahore
Naeem Sarwar Arif Memorial Teaching hospital Lahore
Shahzeena Kaleem Arif Memorial Teaching hospital Lahore
Tayyaba Hamid Arif Memorial Teaching hospital Lahore
Asghar Ali Lahore General Hospital, Lahore
Khalil-ur-Rehman Arif Memorial Teaching hospital Lahore

DOI: https://doi.org/10.51642/ppmj.v36i03.775

Keywords: Foreign Bodies, Surgical Sponges, Postoperative Complications, Intestinal Obstruction, Cesarean Section

Abstract

Gossypiboma is a rare but reported complication. We describe two post-cesarean patients from a rural district who presented within 2–3 months with abdominal pain and fever at ages 20 and 49 years. The uniqueness of these cases lies in the presentation of patients from different age groups and with varied clinical symptoms and signs. One case was diagnosed with gossypiboma on a computed tomography (CT) scan of the abdomen and required urgent exploratory laparotomy due to vague symptoms of intestinal obstruction. The other was initially diagnosed with rectus sheath hematoma on ultrasound, but was found to have gossypiboma intraoperatively. On follow-up, loopograms were performed, and reversal of the ileostomy was done. Both patients are healthy on follow-up.

This case is striking owing to the need for an emergency exploratory laparotomy with double-loop barrel ileostomy, due to secondary bowel necrosis caused by gossypiboma