Intestinal Obstruction Caused by Retained Surgical Swab

Abstract

ABSTRACT: Retained surgical swab (RSS) is an infrequent and avoidable complication after any type of abdomino-pelvic
surgeries which leads to increased morbidity of patient as well as the cost of treatment. We report one such case of a 32 years
old female patient who presented with signs and symptoms of acute intestinal obstruction, 1 year after a cesarean section. On
exploration a mass was found in the region of terminal ileum which was resected followed by end to end anastomosis. Upon
dissection of the mass, a large surgical swab was found inside the lumen of the gut. The mass which is formed around a
retained surgical swab is known as Gossypiboma. Complete intra-luminal migration is very rare and a delayed complication of
RSS and is difficult to diagnose due to vague presentation and inconclusive imaging. Surgical intervention is mainstay of
treatment although it may be removed endoscopically in accessible parts of the gut and may even pass with defecation without
any intervention.