Shin WY, Im CH, Choi SK, Choe YM, Kim KR. Transmural penetration of sigmoid colon and rectum by retained surgical sponge after hysterectomy. World J Gastroenterol 2016; 22(10): 3052-3055 [PMID: 26973401 DOI: 10.3748/wjg.v22.i10.3052]
Corresponding Author of This Article
Sun Keun Choi, MD, Professor, Department of Surgery, Inha University Hospital, Inha University College of Medicine, 27 Inhang-ro, Jung-gu, Incheon 400-711, South Korea. karam66@inha.ac.kr
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Mar 14, 2016; 22(10): 3052-3055 Published online Mar 14, 2016. doi: 10.3748/wjg.v22.i10.3052
Transmural penetration of sigmoid colon and rectum by retained surgical sponge after hysterectomy
Woo Young Shin, Chan Hyuk Im, Sun Keun Choi, Yun-Mee Choe, Kyung Rae Kim
Woo Young Shin, Chan Hyuk Im, Sun Keun Choi, Yun-Mee Choe, Kyung Rae Kim, Department of Surgery, Inha University Hospital, Inha University College of Medicine, Incheon 400-711, South Korea
Author contributions: Shin WY wrote the paper; Choi SK performed the operation and designed the study; Im CH, Choe YM and Kim KR reviewed and revised the report.
Supported by Inha University Research Grant.
Institutional review board statement: This study was reviewed and approved as exemption by the Inha University hospital Institutional Review Board.
Informed consent statement: Study participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no potential conflicts of interest in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sun Keun Choi, MD, Professor, Department of Surgery, Inha University Hospital, Inha University College of Medicine, 27 Inhang-ro, Jung-gu, Incheon 400-711, South Korea. karam66@inha.ac.kr
Telephone: +82-32-8903409 Fax: +82-32-8903549
Received: May 7, 2015 Peer-review started: May 11, 2015 First decision: September 9, 2015 Revised: September 23, 2015 Accepted: November 24, 2015 Article in press: November 24, 2015 Published online: March 14, 2016 Processing time: 301 Days and 20.3 Hours
Abstract
Gossypiboma is a surgical sponge that is retained in the body after the operation. A 39-year-old female presented with vague lower abdominal pain, fever, and rectal discharge 15 mo after hysterectomy. The sponge remaining in the abdomen had no radiopaque marker. Therefore a series of radiographic evaluations was fruitless. The surgical sponge was found in the rectosigmoid colon on colonoscopy. The sponge penetrated the sigmoid colon and rectum transmurally, forming an opening on both sides. The patient underwent low anterior resection and was discharged without postoperative complications.
Core tip: This case involved an unusual migration and placement of a retained surgical sponge; the retained sponge penetrated the intestinal submucosa and migrated to the sigmoid colon and rectum, causing formation of a fistula which had two openings. In this case, the importance of the radiopaque marker was reviewed. Surgical materials with radiopaque markers should be used, which make diagnosis significantly in suspected cases of material being left in the abdominal cavity. Without the radiopaque markers, diagnosis of a retained sponge is difficult, as was the situation in this case. We emphasize the importance of using radiopaque-labeled sponges in all abdominal operations and vigilant adherence to surgical material count in all procedures.
