Gossypiboma: A Hidden Complication of Emergency Caesarean Section – A Rare Case Report and Literature Review

Abstract

Gossypiboma is caused by accidental retention of surgical sponges or swab in the body after the surgery. The abdominal cavity is the most common site of retained surgical sponges, which is usually rarely reported because of the fear of medico legal problems. Factors contributing to sponge retention include disorganized emergency surgeries, prolonged operations, unstable patient conditions, inexperienced personnel, and obesity. Typical symptoms include abdominal pain (42%), palpable masses (27%), and fever (12%). Common complications are fistula formation, abscesses, and intestinal obstruction, predominantly affecting the abdomen (56%), pelvis (18%), and thorax (11%). Surgical removal is the sole treatment option. We present a case of a 30-year-old woman who underwent an emergency caesarean section four months prior and subsequently developed a fistula and pus discharge at the incision site. Diagnosis was confirmed via CT scan, revealing a retained surgical sponge in the Douglas pouch, which was surgically removed.