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Published: December 2012

Open Access Gateway

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

Author affiliations

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

Corresponding Author

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

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Case Rep Gastroenterol 2012;6:754–759

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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.

© 2012 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Published: December 2012

Published online: December 19, 2012
Issue release date: September – December

Number of Print Pages: 6
Number of Figures: 3
Number of Tables: 0


eISSN: 1662-0631 (Online)

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


Open Access License / Drug Dosage / Disclaimer

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