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Vol. 6, No. 3, 2012
Issue release date: September – December
Open Access Gateway
Case Rep Gastroenterol 2012;6:754–759
(DOI:10.1159/000346285)
Published: December 2012

Intestinal Obstruction due to Complete Transmural Migration of a Retained Surgical Sponge into the Intestine

Kato T.a · Yamaguchi K.d · Kinoshita K.a · Sasaki K.a · Kagaya H.a · Meguro T.a · Morita T.b · Takahashi T.c · Tamaki N.e · Horita S.a
Departments of aInternal Medicine, bSurgery and cPathology, Hokkaido Gastroenterology Hospital, Sapporo, dDepartment of Surgery, Japanese Red Cross Kitami Hospital, Kitami, and eDepartment of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan

Abstract

A 56-year-old woman with a history of gynecological surgery for cervical cancer 18 years previously was referred to our hospital for colicky abdominal pain, nausea and vomiting. Intestinal obstruction was diagnosed by contrast-enhanced computed tomography (CT) which showed dilation of the small intestine and suggested obstruction in the terminal ileum. In addition, CT showed a thick-walled cavitary lesion communicating with the proximal jejunum. 18F-fluorodeoxyglucose positron emission tomography showed abnormal uptake at the same location as the cavitary lesion revealed by CT. The patient underwent laparotomy for the ileus and resection of the cavitary lesion. At laparotomy, we found a retained surgical sponge in the ileum 60 cm from the ileocecal valve. The cavitary tumor had two fistulae communicating with the proximal jejunum. The tumor was resected en bloc together with the transverse colon, part of the jejunum and the duodenum. Microscopic examination revealed fibrous encapsulation and foreign body giant cell reaction. Since a retained surgical sponge without radiopaque markers is extremely difficult to diagnose, retained surgical sponge should be considered in the differential diagnosis of intestinal obstruction in patients who have undergone previous abdominal surgery.

 goto top of outline Author Contacts

Takashi Kato
Department of Internal Medicine, Hokkaido Gastroenterology Hospital
Honcho 1-jo, 1-chome, Higashi-ku, Sapporo 065-0041 (Japan)
E-Mail tks-kato@hgh.or.jp


 goto top of outline Article Information

Published online: December 19, 2012
Number of Print Pages : 6
Number of Figures : 3,


 goto top of outline Publication Details

Case Reports in Gastroenterology

Vol. 6, No. 3, Year 2012 (Cover Date: September - December)

Journal Editor: Urrutia R. (Rochester, Minn.), Lomberk G. (Rochester, Minn.)
ISSN: 1662-0631 (Print), eISSN: 1662-0631 (Online)

For additional information: http://www.karger.com/CRG


Open Access License / Drug Dosage

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