Gossypiboma: Retained Surgical Sponge afer Total Abdominal Hysterectomy
with Spontaneous Transurethral Partal Extrusion
Ali Samba
1
, Kareem Mumuni
1
and Amala Chukwu Okpala
2
1
Department of OBGYN, University of Ghana School of Medicine and Dentstry, Ghana
2
Department of OBGYN, Korle-Bu Teaching Hospital, Ghana
Corresponding author: Ali Samba, Department of OBGYN, University of Ghana School of Medicine and Dentstry, Korle-Bu. Accra, Ghana, Tel:
+0023326747367; E-mail: abmasa@yahoo.com
Received date: July 19, 2016; Accepted date: January 10, 2017; Published date: January 12, 2017
Citaton: Samba A, Mumuni K, Okpala AC. A Case Report of Pregnancy in Rudimentary Horn, Gynecol Obstet Case Rep. 2017, 3:1.
Abstract
Retenton of surgical materials occurs afer diverse
surgical procedures, ofen tmes afer countng of surgical
materials pre and post operatvely. A 45 year old female
in whom a surgical sponge was lef in the pelvis post
hysterectomy with spontaneous transurethral partal
extrusion is reported. Risk factors that could predispose to
a gossypiboma and suggestons to prevent it are reported.
Introducton
Retenton of surgical sponges intra-abdominally is an
uncommon surgical error and a rare but preventable
occurrence [1,2]. The true incidence may never be known as
the embarrassment, humiliaton, job loss and law suit that
could atend this situaton ofen leads to shelving of many
cases especially in the developing world [3].
The real incidence of retenton of surgical sponges intra-
abdominally is yet to be well described. Reports have shown it
to be in the range of 1 in 100 to 3000 for all surgical
interventons and 1 in 1000 to 1500 for intra-abdominal
operatons [4].
A case of a woman in whom a surgical sponge was
inadvertently lef in her pelvis post abdominal hysterectomy
which migrated via a vaginal vault fstula into the bladder with
partal extrusion through the urethral orifce is reported here.
Case Report
A 45 year old multparous woman presented with an eight
week history of dysuria, fever, chills, frequency, nocturia,
straining, feeling of incomplete emptying, urge incontnence
and lower abdominal pain associated with a three day history
of protrusion of a whitsh substance from the urethral orifce
(Figure 1).
Figure 1 Gross appearance of surgical sponge protruding
from urethral orifce.
A year ago she had undergone a total abdominal
hysterectomy for bleeding uterine fbroids at a private clinic;
and had no symptoms untl eight weeks before reportng to
the clinic. Previous treatments for recurrent urinary tract
infectons were of no avail.
Figure 2 Suspected vesico-vaginal fstula outlined by arrow.
A cystogram done revealed a structure which resembled a
surgical sponge situated between the bladder and vagina and
an urethro-vaginal fstula was suspected as contrast outlined
both the vagina and gauze during inital phase of contrast
administraton (Figure 2).
Case Report
iMedPub Journals
http://www.imedpub.com/
DOI: 10.21767/2471-8165.1000039
Gynecology & Obstetrics Case Report
ISSN 2471-8165
Vol.3 No.1:39
2017
© Copyright iMedPub | This article is available from: http://gynecology-obstetrics.imedpub.com/
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