A Rare Medicolegal Cause of Acute Abdomen: Gossypiboma Causing Enteroenteric and Enterocutaneous Fistula

Year 2022, , 269 - 273, 31.08.2022

Recep Çağlar

https://doi.org/10.47493/abantmedj.1068806

Abstract

Gossypiboma are surgical tampons that are forgotten in the operation area and cause serious complications in the patient. The most frequently forgotten foreign body in operations are surgical tampons. Early recognition of gossypiboma is important to minimize the risk of morbidity and mortality in the patient. While they may be asymptomatic, they may cause complications such as perforation, obstruction, peritonitis, intra-abdominal or enterocutaneous fistula, abscess and sepsis. In the differential diagnosis, hematoma, pseudocyst and tumors should be considered. In computed tomography (CT), the spongy appearance formed as a result of the air trapped in the cotton pad is characteristic. Its treatment is surgery. If possible, the use of radiopaque labeled tampons can be avoided by taking preventive measures such as careful counting of surgical materials before and after each surgical operation. It should be kept in mind in the differential diagnosis of gossypiboma in patients with a history of previous surgery and diagnosed with an intra-abdominal mass.

Keywords

Gossypiboma, Previous Surgery, Medicolegal Problems

Nadir Medikolegal Bir Akut Batın Nedeni: Enteroenterik ve Enterokutanöz Fistüle Neden Olan Gossipiboma

Abstract

Gossipiboma, operasyonda ameliyat bölgesinde unutulan ve hastada ciddi komplikasyonlara neden olan cerrahi tamponlardır. Operasyonlarda en sık unutulan yabancı cisim cerrahi tamponlardır. Hastada morbidite ve mortalite riskini en aza indirmek için gossipibomanın erken tanınması önemlidir. Asemptomatik olabileceği gibi, perforasyon, obstrüksiyon, peritonit, intraabdominal veya enterokutanöz fistül, abse ve sepsis gibi komplikasyonlara neden olabilirler. Ayırıcı tanıda hematom, psödokist ve tümörler düşünülmelidir. Bilgisayarlı tomografide (BT) pamuklu tampon içinde havanın hapsolması sonucu oluşan süngerimsi görünüm karakteristiktir. Tedavisi cerrahidir. İmkan varsa radyoopak işaretli tampon kullanılması, her cerrahi operasyon öncesi ve sonrasında cerrahi malzemelerin dikkatli sayımı gibi önleyici tedbirler alınarak önlenebilir. Geçirilmiş ameliyat öyküsü olan ve karın içi kitle tanısı alan hastalarda gossipiboma ayırıcı tanıda akılda tutulmalıdır.

Keywords

Gossipiboma, Geçirilmiş Cerrahi, Medikolegal Problemler

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