Lower gastrointestinal bleeding due to colonic fistula caused by a gossypiboma : Case report and literature review
Gómez-Jurado, María José (Hospital Universitari Vall d'Hebron)
Curell, Anna (Hospital Universitari Vall d'Hebron)
Martín, Rocío (Hospital Universitari Vall d'Hebron)
García Ruiz de Gordejuela, Amador (Hospital Universitari Vall d'Hebron)
Armengol Carrasco, Manuel (Universitat Autònoma de Barcelona)

Data:	2020
Resum:	Even in modern surgery, human mistakes cannot be totally avoided. Retained surgical items are among the most feared ones. Forgotten sponges inside patients can cause a wide range of complications due to the foreign body reaction, called gossypiboma. The incidence of gossypibomas in the literature is probably underreported due to its legal implications; however, we must know its consequences and highlight the importance of the prevention strategies. We present a case where only preventive measures would have avoided its fatal outcome. An 85-year-old male, previous left nephrectomy 12 years before, came to the emergency room with hematochezia and hemodynamic instability. An emergent angio-CT revealed a 12 cm mass due to a gossypiboma near the descending colon; the presence of air suggested an infection and/or fistulization to the bowel. It was decided not to perform invasive procedures, resulting in the patient's death. Gossypibomas can remain asymptomatic for years, being diagnosed when causing an obstruction, malabsorption, septic symptoms or even spontaneously. This may lead to high morbidity and mortality rates. In order to prevent it, different strategies have been described, with the objective to intensify surveillance. When diagnosed, laparotomy, laparoscopic and even endoscopic procedures have been performed successfully. We suggest putting all our efforts in identifying high risk patients and surgeries, training the OR team and enhancing protocols and checklists to minimize any preventable errors.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Gossypiboma ; Retained surgical item ; Foreing body ; Lower gastrointestinal bleeding ; Colonic fistula ; Complication
Publicat a:	International Journal of Surgery Case Reports, Vol. 72 (may 2020) , p. 59-62, ISSN 2210-2612

DOI: 10.1016/j.ijscr.2020.05.053
PMID: 32506032

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