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Case Report



Spontaneous expulsion of a retained surgical sponge through anus, a rare case report with review of literature

Azher Mushtaq, Shabir Ahmad Mir, Zubair Gul Lone, Fahad ul Islam Mir.


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Abstract
Retained foreign bodies also called as gossypiboma is an uncommon surgical mishap that is associated with a lot of litigations and law suits in surgical practice. While most cases of Retained Surgical Sponges (RSS) require surgical exploration to avoid patient morbidity and mortality, We present a rare case of a retained surgical sponge where in the patient presented with intestinal obstruction and the foreign body got spontaneously expelled via rectum.A 42 year old female presented to the casuality of our hospital with history of pain abdomen and vomiting with a history of LSCS done 4 months back.Ultrasound abdomen revealed a large pelvic collection measuring 300cc. The patient was operated upon and the pelvic collection was drained. After about 4 - 5 months the patient presented with feature of Subacute Intestinal obstruction and the X-ray done revealed a radiodense line in Right lower abdomen suggestive of a Retained Surgical Sponge (RSS). CT scan confirmed the possibility of a retained sponge with an intraluminal location. The patient however did well with conservative regime and so was continued on conservative management and followed with serial X-rays.The patient was discharged on the 10th day with an advice to check her stools regularly for the passage of any unusual material. The patient reported 20 days later and confirmed the passage of pieces of gauze like material with her stools on a few occasions.

Key words: Gossypiboma, Retained Surgical Sponge, Intsetinal obstruction.



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