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A Serious Medicolegal Problem After Surgery: Gossypiboma

Gümüş, Metehan*; Gümüş, Hatice; Kapan, Murat*; Önder, Akn; Tekbaş, Güven; Baç, Bilsel*

The American Journal of Forensic Medicine and Pathology: March 2012 - Volume 33 - Issue 1 - p 54–57
doi: 10.1097/PAF.0b013e31821c09fe
Original Articles

After surgery, the most common foreign bodies retained in the abdominal cavity are the surgical sponges. The aim of the present study was to emphasize the importance of gossypiboma, which is a serious and medicolegal problem. The records of 12 patients with a confirmed diagnosis of gossypiboma after abdominal surgery at Dicle University Hospital were retrospectively reviewed between January 1994 and December 2009. Eight of the 12 patients were females, and 4 were males. Previously, 7 patients had been operated on electively, and 5 had undergone operations on an emergency basis. Abdominal ultrasonography clearly demonstrated gossypibomas in 5 patients, and computed tomography demonstrated a more precise image of retained surgical sponges in 3 patients. One patient died because of ventricular fibrillation; the other 11 patients were discharged in good health. To eliminate the risk of gossypibomas, all sponges should be counted at least twice (once preoperatively and once postoperatively); use of small sponges should be avoided during laparotomy, and only sponges with radiopaque markers should be used. The surgeon should explore the abdomen before closure. In cases in which the sponge count is uncertain, an abdominal x-ray should be performed before closure.

From the Departments of *General Surgery and †Radiology, Medical Faculty, Dicle University, Diyarbakir, Turkey.

Manuscript received February 10, 2010; accepted March 27, 2010.

All authors have no financial interests relating to the article.

The authors report no conflicts of interest.

Reprints: Metehan Gümüş, Department of General Surgery, Medical Faculty, Dicle University, Yenişehir 21280, Diyarbakır, Turkey. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.