Simultaneous extraction of a retained surgical gauze from bladder and uterus 17 years after cesarean section : a rare case report

Abstract EN

Introduction : Gossypiboma is defined as retained foreign object (sponge, needle, and instrument) in patient’s corpus after operation that is recognized as a medical error.

It may induce catastrophic implications for the patient and medical care providers.

We present a case with a 17-year-old gossypiboma after cesarean section.

Case Presentation : A 49-year-old woman was admitted to the outpatient clinic of Rasool-e-Akram hospital of Tehran, Iran, in 2016 presenting with abnormal uterine bleeding (AUB), abdominal pain, and urinary symptoms for many years.

She underwent hysteroscopy.

Operative findings included intrauterine synechiae and a polypoid lesion.

Besides, a thread-like foreign body was observed in the anterior surface of the uterine cavity, which was suspected as a cesarean section suture material that was extracted.

After hysteroscopy, uterine bleeding stopped although abdominal pain and urinary symptoms maintained.

Voiding cystourethrogram (VCUG) and MRI revealed a mass between uterus and bladder.

Then, laparotomy was performed.

After opening the abdominal wall under general anesthesia, we explored internal organs and encountered a necrotic mass revealing an old organized gauze between bladder and uterus, which infiltrated the uterus and trigon.

It was extracted and then, hysterectomy and bladder repair were carried out