CLINICAL AND DIAGNOSTIC FEATURES OF GOSSYPIBOMA MIMICKING MALIGNANT GYNECOLOGIC TUMORS

Authors:

Abstract:

With the purpose to analyze the clinical presentation, imaging characteristics, and diagnostic challenges of gossypiboma in gynecologic patients we conducted a retrospective single-center case series from Azerbaijan Medical University (n=10, 2017-2021) supplemented by systematic literature cases (n=10, 2020-2025) to create an enhanced dataset of 20 cases. Comprehensive statistical analysis included risk factor assessment, imaging correlation, and outcome evaluation. No statistically significant risk factors for complications were identified, though emergency surgery (OR 3.00) and prolonged surgery >3 hours (OR 5.62) showed numerically higher odds. In our actual-case level data, computed tomography imaging demonstrated characteristic spongiform appearance with gas bubbles in 85 % of cases, while magnetic resonance imaging revealed pathognomonic whorled stripes pattern in 60 %. Complications occurred in 35 % of cases, with no mortality observed. Implementation of standardized diagnostic algorithms, and adoption of modern prevention technologies are essential for reducing incidence and improving outcomes.

Keywords:

gossypiboma textiloma retained surgical sponge gynecologic oncology diagnostic imaging surgical safety prevention protocols

References:

1. Alemu BN, Tiruneh AG. Gossypiboma: A Case Series and Literature Review. Ethiop J Health Sci. 2020 Jan;30(1):147-149. doi: 10.4314/ejhs.v30i1.19.
2. De Paola L, Napoletano G, Cirillo B, Duranti G, Zaami S, Mingoli A, et al. Textiloma: surgical and forensic implications of medical negligence. A case report and literature review. Int J Legal Med. 2025 Nov;139(6):2807-2814. doi: 10.1007/s00414-025-03547-6.
3. El Zemity H, Hakami N, Alfaki MAA, Khurizi M, Al-Zahrani A Sr. Intra-Abdominal Gossypiboma: A Rare Cause of Palpable Abdominal Mass With a Review of Literature. Cureus. 2020 Oct 13;12(10):e10930. doi: 10.7759/cureus.10930.
4. Elamin HOA, Masoud MS, Mohamed Ali KSE, Fadl HAO, Hamza AHA, Basheer HAM, et al. Unintentionally retained lap sponge mimicking an ovarian cyst two years after Caesarean section in a 37-year-old patient: case report of a rare "never event" in Sudan. Patient Saf Surg. 2024 Aug 16;18(1):26. doi: 10.1186/s13037-024-00407-x.
5. Enebe JT, Ilo CA, Ofor IJ, Chukwubuike KE, Omeke CA, Udeozor NV, et al. Gossypiboma: Spontaneous trans-urethral migration of a forgotten surgical gauze sponge 5 years post hysterectomy in grand multiparous post-menopausal woman. Int J Surg Case Rep. 2020;71:168-171. doi: 10.1016/j.ijscr.2020.04.104.
6. Gavrić Lovrec V, Cokan A, Lukman L, Arko D, Takač I. Retained surgical needle and gauze after cesarean section and adnexectomy: a case report and literature review. J Int Med Res. 2018 Nov;46(11):4775-4780. doi: 10.1177/0300060518788247.
7. Grassi S, Focardi M, Santori F, Guerini M, Ferri E, Ferretti G, et al. Lost and found: trends in litigation and compensation related to retained surgical foreign bodies. Front Med (Lausanne). 2025 Apr 1;12:1526271. doi: 10.3389/fmed.2025.1526271.
8. Gualniera P, Mondello C, Scurria S, Oliva A, Grassi S, Pizzicannella J, et al. Experience of an Italian Hospital Claims Management Committee: A tool for extrajudicial litigations resolution. Leg Med (Tokyo). 2020 Feb;42:101657. doi: 10.1016/j.legalmed.2019.101657.
9. Kato T, Yamaguchi K, Kinoshita K, Sasaki K, Kagaya H, Meguro T, et al. Intestinal Obstruction due to Complete Transmural Migration of a Retained Surgical Sponge into the Intestine. Case Rep Gastroenterol. 2012 Sep;6(3):754-9. doi: 10.1159/000346285.
10. Khan AZ, Fatima T, Kafeel U, Afzal MF, Asif S, Ghumman AR. Preventable morbidities of a successful intervention, Textiloma/Gossypiboma: A case series. J Pak Med Assoc. 2023 Apr;73(4):888-891. doi: 10.47391/JPMA.6199.
11. Obeidat KA, Aleshawi AJ, Alebbini MM, Bani Yasin SN. Abdominal Intraluminal Gossypiboma: Demographics, Predictors of Intraluminal Site, Diagnostic and Treatment Measures. Clin Exp Gastroenterol. 2020 Feb 27;13:65-72. doi: 10.2147/CEG.S236179.
12. Papaoikonomou MA, Michailidou E, Pogiatzis C, Michailidi ME, Panselinas G. Jejunal Gossypiboma Mimicking a Gastrointestinal Stromal Tumor: A Case of a Rare Iatrogenic Complication and Review of the Literature. Cureus. 2024 Dec 13;16(12):e75651. doi: 10.7759/cureus.75651.
13. Sankpal J, Tayade M, Rathore J, Parikh A, Gadekar D, S SF, Sankpal S. Oh, My Gauze!!!- A rare case report of laparoscopic removal of an incidentally discovered gossypiboma during laparoscopic cholecystectomy. Int J Surg Case Rep. 2020;72:643-646. doi: 10.1016/j.ijscr.2020.04.058.
14. Shin WY, Im CH, Choi SK, Choe YM, Kim KR. Transmural penetration of the sigmoid colon and rectum by a retained surgical sponge after hysterectomy. World J Gastroenterol. 2016 Mar 14;22(10):3052-5. doi: 10.3748/wjg.v22.i10.3052.
15. Stawicki SP, Cook CH, Anderson HL 3rd, Chowayou L, Cipolla J, Ahmed HM, et al; OPUS 12 Foundation Multicenter Trials Group. Natural history of retained surgical items supports the need for team training, early recognition, and prompt retrieval. Am J Surg. 2014 Jul;208(1):65-72. doi: 10.1016/j.amjsurg.2013.09.029.

Publication:

«World of Medicine and Biology» Vol. 22 No. 97 (2026), pp. 70-74
UDC 618.1-089:616-003.6

DOI:

https://doi.org/10.26724/2079-8334-2026-3-97-70-74