Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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January 10, 2019
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.
