January 10, 2019
A 44-year-old man with a history of surgical L4-L5 decompression for cauda equina syndrome who presented with low back pain radiating to both lower limbs and had urinary retention and incontinence for the last 2.5 months.
Post Laminectomy Gossypiboma
- Background
- The term gossypiboma is used to refer to masses produced by retained cotton or woven fabrics. The first case of a gossypiboma was reported by Wilson in 1884. Gossypibomas are most frequently seen after abdominal surgery, usually within peritoneal recesses. However, they can also be found in the chest, extremities, CNS, and breast.
- Delays in the detection can result in increased morbidity and even mortality. These are most frequently observed in obsese patients, during emergency operations, and after laparoscopic interventions.
- Their time of clinical presentation varies any from immediately postoperatively to several decades after initial surgery.
- Clinical Presentation
- Variable depending on the location.
- Key Diagnostic Features
- Abscess: Usually has a thinner wall, central diffusion restriction, and adjacent inflammatory changes. Fluid aspiration may be needed to distinguish both entities.
- Haematoma: Does not enhance. Appearances vary according to stage of the blood degradation products. Can have fluid-fluid levels.
- Treatment
- Excision and removal is the treatment of choice.
