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Objective <p>To report a rare case of complex pelvic mass from retained foreign body following cesarean section, highlighting long-term surgical complications.</p> Introduction <p>Gossypiboma, an accidentally retained surgical sponge or gauze within the body, represents a serious yet underreported surgical complication. Presentations vary from asymptomatic to obstruction, peritonitis, adhesions, fistula, abscess formations. It can cause exudative or fibrinous response. Exudative pattern presents early in postoperative period due to local inflammation. Fibrinous response occurs later through encapsulation of retained foreign object within scar tissue.</p> Participant <p>A 44-year-old woman (Para 1, Living 1) with previous cesarean section 15 years prior presented with complex clinical picture. Her symptoms included abdominal lump for 6 months, chronic abdominal pain, dyspareunia, and heavy menstrual bleeding spanning five years. Clinical examination revealed pulled up and effaced cervix with 22-week-sized pelvic mass. Imaging studies (MRI with CT correlation) demonstrated a 12 × 14 × 15 cm cystic lesion, adherent to anterior uterine wall and abutting bladder dome. A linear hyperdense coiled structure with metallic streak artifacts was suggestive of retained foreign body. Additional findings included bilateral mild hydroureteronephrosis.</p> Interventions <p>Surgical intervention was performed which involved laparoscopic pus drainage and removal of sponge presumably left during initial cesarean section 15 years earlier.</p> Conclusion <p>Retained foreign objects is one of the most dreadful complications of surgery. This case underscores the critical importance of meticulous surgical practices and thorough diagnostic evaluation of persistent gynecological symptoms. Preventing retained foreign objects remains paramount, with accurate surgical item counting serving as primary safeguard against such complications.</p>

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Forgotten but Not Gone: The Risks of Retained Surgical Items(Gossypiboma)

  • 期刊论文

  • 发表日期：

    2026年7月23日

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  • Isha Kriplani,
  • Nidhi Choudhary,
  • Seema Sharma,
  • Alka Kriplani

摘要

Objective

To report a rare case of complex pelvic mass from retained foreign body following cesarean section, highlighting long-term surgical complications.

Introduction

Gossypiboma, an accidentally retained surgical sponge or gauze within the body, represents a serious yet underreported surgical complication. Presentations vary from asymptomatic to obstruction, peritonitis, adhesions, fistula, abscess formations. It can cause exudative or fibrinous response. Exudative pattern presents early in postoperative period due to local inflammation. Fibrinous response occurs later through encapsulation of retained foreign object within scar tissue.

Participant

A 44-year-old woman (Para 1, Living 1) with previous cesarean section 15 years prior presented with complex clinical picture. Her symptoms included abdominal lump for 6 months, chronic abdominal pain, dyspareunia, and heavy menstrual bleeding spanning five years. Clinical examination revealed pulled up and effaced cervix with 22-week-sized pelvic mass. Imaging studies (MRI with CT correlation) demonstrated a 12 × 14 × 15 cm cystic lesion, adherent to anterior uterine wall and abutting bladder dome. A linear hyperdense coiled structure with metallic streak artifacts was suggestive of retained foreign body. Additional findings included bilateral mild hydroureteronephrosis.

Interventions

Surgical intervention was performed which involved laparoscopic pus drainage and removal of sponge presumably left during initial cesarean section 15 years earlier.

Conclusion

Retained foreign objects is one of the most dreadful complications of surgery. This case underscores the critical importance of meticulous surgical practices and thorough diagnostic evaluation of persistent gynecological symptoms. Preventing retained foreign objects remains paramount, with accurate surgical item counting serving as primary safeguard against such complications.