Small bowel obstruction and ileocolic fistula caused by post-myomectomy Gossypiboma transmural migration: A case report and review of the literature
| Autor: | Mohamed Eltayeb Abdelrahman Naiem, Mohamed Elfatih A. Elgurashi, Husameldin Mahmoud Osman Nafi, Nassir Alhaboob Arabi, Alamin Adil Alsharief Mohammedkhair, S.H. Suliman |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
business.industry Gossypiboma Fistula medicine.medical_treatment Colostomy Transverse colon Sigmoid colon Case Report Ileocolic fistula medicine.disease digestive system diseases Surgery Bowel obstruction medicine.anatomical_structure Acute abdomen Retained intra-abdominal sponges medicine medicine.symptom business Abdominal surgery |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Introduction Post-myomectomy Gossypiboma causing Ileo-colic fistula is tremendously rare; it may present as a tumor and stand a diagnostic challenge. The duration between the primary procedure and the presentation is unpredictable. Case presentation A 37-year-old Sudanese/African woman presented with a 4-month history of left iliac fossa mass, pain, anorexia, and persistent, recurrent vomiting with episodes of diarrhea during the last month PTP. She had two gynecological surgeries. Abdominal X-ray & abdominopelvic CECT showed a left iliac fossa pelvic-abdominal collection, distal small bowel partial obstruction, and contrast passage from the small bowel to the sigmoid colon. Diagnosis retained foreign body with abscess causing distal ileal subacute obstruction and an ileo-sigmoid fistula. Surgical exploration, extraction of Gossypiboma with small bowel resection, primary sigmoid colon repair, and a protective transverse colon stoma were done. Six weeks later, colostomy closed after distal loopogram and flexible-sigmoidoscopy. Clinical discussion A missed intraperitoneal gauze is the top differential diagnosis in patients presenting with acute abdomen after recent abdominal surgery. Transmural migration is slow but leads to difficult clinical situations, peritonitis, or fistulas. Our case reflects the light on the importance of the golden rule of perioperative gauze count and documentation. Thus, minimizing the surgical complications and preventing severe postoperative morbidities. Conclusion Entero-colic fistula due to trans mural migration is not frequently encountered, and its complications can lead to morbidities and even mortality if not promptly diagnosed and treated. Strict adherence to the golden rule of counting and prevent such life-threatening complications and improves patients' safety. Highlights • Post-myomectomy Gossypiboma is rare and can present as a mass or tumor. • The duration between the primary procedure and the presentation scenario is unpredictable. • Gossypiboma transmural migration causing ileocolic fistula can be difficult to diagnose with only a few reported cases. • Strict perioperative counting protocols can decrease this notorious never event incidence. |
| Databáze: | OpenAIRE |
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