Diagnostic dilemma: A strange mass of a woman’s waist was a sponge left in the C section

Patient: 38-year-old woman from New Delhi

Symptoms: The patient had given birth via emergency caesarean section in another country, but after surgery she noticed pain on the right side of her lower abdomen. The doctors at the time told her that it was normal postoperative pain, but they didn’t explore it further. Eventually, a mass formed on the site, intensifying the pain in the woman.

What happened next: Four years after her C-section, the patient sought further medical advice at New Delhi Hospital in 2014. The doctor performed ultrasound and CT scans to reveal the cyst at the site of the pain. However, they still couldn’t convey what was the nucleus of the cyst. Their initial speculation was that it was a mesenteric cyst, a type of benign tumor that could cause discomfort and pain.

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To confirm this potential diagnosis, they turned to MRI. This caused more confusion as it revealed what appears to be a thick membrane at the core of the mass. Rather than a benign tumor, doctors suspected the cyst had enveloped tapeworms. For example, if she had eaten food contaminated with tapeworm eggs, she would have been able to enter her body.

Treatment: Unable to identify the contents of the cyst through multiple imaging techniques, the doctor decided to surgically remove the mystical mass and relieve the woman from her pain. This procedure required blocking part of the small intestine where the cysts were fused. The patient followed this procedure to recover normally and left the hospital 7 days later.

Diagnosis: Cysts were measured at a length of 8 inches (20 cm). It is usually considerably larger than a typical mesenteric cyst, and is usually not less than 2 inches (5 cm) in diameter. When the cyst was opened, the doctor discovered a surgical sponge implanted in the center.

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The cyst was measured nearly 8 inches long and captivated a surgical sponge (white object) abandoned from the patient’s front c-section.

The immune system treats foreign bodies in the body as a threat and tries to break them down and remove them. However, the sponge couldn’t easily collapse, so the body’s defenses wrapped it in a cyst to hide the potential threat, doctors concluded in reporting the incident.

(Sponges used in surgery must be infertile, which may help explain the lack of infection in women.

What makes the case unique is that surgeons rarely leave sponges or other objects behind the abdomen of patients after surgery – a complication known as gossipipoboma – it occurs in about 1 in 1,500 to 1,000 surgeries, suggesting.

Such a simple mistake can occur if a doctor needs to have a hurry to have surgery. If the surgical team is changed mid-surgery; or if the medical staff loses sight of the number of sponges used during the course of the procedure. A sponge is required to absorb blood during surgery, but when it turns red, it can be blended with the flesh and overlooked when it’s time to close the wound.

Gossypibomas is more difficult to detect after surgery is complete. In this case, the sponge was made of material that cannot be detected by a typical scan, so it was not displayed in three different imaging types. Following this event, the case report authors recommended that only radio-detectable sponges be used during future surgeries and that the number of sponges present at the start of the surgery was counted to ensure that they are not present in the body.