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What Is Gossypiboma?

Gossypiboma, a term unfamiliar to many, refers to a surgical complication where a piece of cotton gauze or a towel is inadvertently left inside a patient's body post-operation. This oversight can lead to serious health issues. Understanding its causes and prevention is crucial for patient safety. How can such a risk be mitigated in modern medicine? Continue reading to uncover the measures.
Dan Harkins
Dan Harkins

When a sponge or some other surgical equipment is left inside a patient who's undergone surgery, the resulting diagnosis is called gossypiboma. These formations might not appear until years later, when pain or infection become impossible to ignore. Though some characteristics of this disorder are the same as all others, doctors must consider each case individually based on each patient's prior surgical procedures.

Though this phenomemon is rare, medical literature has chronicled many cases of gossypiboma, complete with radiological images. A post-operative patient — often months or even years after surgery — might complain of localized pain at the surgical site, see a cyst that is growing in size, or even suffer symptoms of an internal infection. The symptoms of an internal infection are typically a high fever and other flu-like symptoms like aching and lethargy.

Gossypiboma may result in flu-like symptoms.
Gossypiboma may result in flu-like symptoms.

Depending on the type of surgery, gossypiboma could reveal itself in any number of other symptoms. An operation involving the digestive tract, for instance, could lead to intestinal obstruction that causes nausea, vomiting, weight loss and pain. Left behind in the lungs, by contrast, a growth could form that causes severe respiratory difficulty.

Gossypiboma can typically be identified by an x-ray, but follow-up surgery is most often needed to remove the unwelcome surgical instrument. Though sponges appear to be the most common material left behind, several other cases have involved tools like bone curettes, forceps, gauze, scissors, nerve hooks and tissue clamps that can easily be overlooked if not careful. According to a 2008 report by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality, about one retained foreign object was left behind out of every 5,500 surgical procedures. This statistic was gleaned after an analysis of nearly 200,000 operations.

When a sponge or some other surgical equipment is left inside a patient who's undergone surgery, the resulting diagnosis is called gossypiboma.
When a sponge or some other surgical equipment is left inside a patient who's undergone surgery, the resulting diagnosis is called gossypiboma.

When a surgical instrument is left behind, the body's reaction is often to encapsulate the material. Calcification and fat buildup can form around the mass, which eventually might appear as a cyst or tumor. What a doctor initially believes might be an abnormal tissue mass on an x-ray could indeed be the remains of a surgery that, until then, was considered a success.

Surgical sponges are the most common material left behind during surgeries.
Surgical sponges are the most common material left behind during surgeries.

Radiological tests can easily identify certain instruments like forceps or nerve hooks, but gauze or sponge might be so encapsulated in fat and tissue that it will appear to be a potentially malignant tumor. Most manufacturers of these items in 2011 include radiopaque fibers that can be detected by radiologists. Surgeons and their assistants often count instruments at the end of a procedure before closing up a patient. Some technology like bar coding and radiofrequency detection lets surgeons use a scanner to quickly ascertain if anything has been left inside.

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    • Gossypiboma may result in flu-like symptoms.
      By: tiplyashina
      Gossypiboma may result in flu-like symptoms.
    • When a sponge or some other surgical equipment is left inside a patient who's undergone surgery, the resulting diagnosis is called gossypiboma.
      By: naypong
      When a sponge or some other surgical equipment is left inside a patient who's undergone surgery, the resulting diagnosis is called gossypiboma.
    • Surgical sponges are the most common material left behind during surgeries.
      By: Sherry Young
      Surgical sponges are the most common material left behind during surgeries.
    • In rare cases, gossypiboma can result from a surgical instrument that was left inside the patient after a procedure.
      By: redcarpett
      In rare cases, gossypiboma can result from a surgical instrument that was left inside the patient after a procedure.
    • Gossypiboma can cause an internal infection that results in lethargy and a fever.
      By: WavebreakmediaMicro
      Gossypiboma can cause an internal infection that results in lethargy and a fever.