CT features of intrathoracic gossypiboma (textiloma) (original) (raw)

Intrapericardial gossypiboma found 14 years after coronary artery bypass grafting

Journal of Cardiothoracic Surgery

Background: Foreign body left after surgery surrounded by a foreign body reaction otherwise known as gossypiboma, have been first described in 1884. Although it occurs rarely, it can lead to various complications which include adhesions, abscess formation and related complications. Intrathoracic gossypiboma is a rare but serious consequence of negligence, mainly during abdominal and cardiothoracic surgery that can lead to severe medical consequences. This paper aims to raise awareness among surgeons and nurses in the operating room to prevent such errors and future complications. Case presentation: A patient with a history of coronary arterial bypass grafting performed 14 years ago, presented with shortness of breath and dry cough. A chest X-ray revealed a large mass in the left hemithorax. The chest CT demonstrated the presence of a heterogeneous density mass of 11 cm and smooth edges in the middle mediastinum, next to the heart and partially intrapericardial. Because clinical and radiologic evidence revealed presence of a mass, we did proceed with CT guided FNA of the mass. The cytology findings confirmed an inflammatory lesion. Based on patient symptomatology and the evidence of a mass, allegedly compressing the cardiopulmonary structures in vicinity, we performed surgical exploration. An old and degraded piece of surgical swap was found and removed through an anterolateral left thoracotomy. The post-operative course was excellent. Conclusions: Forgetting surgical swaps during surgery is a medical fault. To avoid them, surgical units should design and implement a surgical inventory process to account for surgical instruments or surgical swaps. Failure to make a proper diagnosis of cases such as these can lead to further health complications in these patients. The iatrogenic foreign material seen as a mass in the radiologic films had not been previously noticed by other health professionals although the patient had undergone X-ray and cardiac ultrasound examinations in the 14 years following coronary bypass surgery. Once the causative agent was identified and removed the patient returned to normal activity.

Imaging Features of Chest Wall Gossypiboma

Journal of Ultrasound in Medicine, 2009

ossypibomas, or "textilomas," are retained surgical sponges or swabs that are uncommon complications of any surgical procedure. Gossypiboma is derived from Latin (gossypium, cotton) and Swahili (boma, place of concealment). Most cases have been reported in the abdomen or pelvis, and fewer intrathoracic parenchymal and pleural gossypibomas have been described. 1-7 To our knowledge, only 1 case of a chest wall gossypiboma has been previously discussed, 3 and we present the findings of an additional case in a young female patient.

What thought to be a cardiac tumor turns out to be a remnant of former surgery

2020

BACKGROUND A textiloma is a rare retained surgical swab with probable serious post-operation complications. CASE REPORT Here, we reported an asymptomatic patient who had past history of coronary artery bypass grafting (CABG) fourteen months ago and referred to our institute for left atrial mass removal. Echocardiography and chest computed tomography (CT) scan revealed a non-homogenous non-mobile mass and a heterogeneous lesion with low-density as well as high-density areas with spot calcification and gas bubbles at left atrium level, respectively. CONCLUSION Despite being rare after CABG, textiloma should be considered in the differential diagnosis in case of any suspicious chest mass even in asymptomatic patients.

A Large Mass in the Right Anterior Chest

Journal of Cardiothoracic and Vascular Anesthesia, 2012

A 70-YEAR-OLD MAN with a history of coronary artery disease, severe aortic stenosis, obesity, type-2 diabetes mellitus, hypertension, and chronic obstructive pulmonary disease was admitted for coronary artery bypass grafting and aortic valve replacement. The physical examination showed a morbidly obese individual with a barrel chest; he was in no acute distress. He had diffuse faint wheezes and decreased breath sounds bilaterally (right greater than left). A pulmonary function test showed a forced expired volume in 1 second of 30% of predicted. Chest radiographs were obtained as part of the preoperative evaluation and displayed a large density in the right anterior chest (Figs 1 and 2). A thoracic computed tomographic scan confirmed the presence of a large mass in the anterior mediastinum and right chest (Fig 3). What is the diagnosis?

Foreign Bodies in Pleura and Chest Wall

Annals of Thoracic Surgery, 2008

Background. In contrast to other locations, foreign bodies in pleura and chest wall have been rarely reported and there is no consensus with regard to treatment.

Retained intra- thoracic surgical pack mimicking as recurrent aspergilloma

Journal of clinical and diagnostic research : JCDR, 2012

An intrathoracic gossypiboma is a rare condition. We are reporting a case of intrathoracicgossypiboma which was misdiagnosed as a recurrent aspergilloma. In our patient, the gossypiboma manifested as a pleural- based extra pulmonary mass which had a large contact area with the pleura and it displayed an extra pulmonary location. A retained surgical swab (gossypiboma) is a rare but an important complication of an intra- thoracic surgery. The diagnosis is usually overlooked, as in our case, resulting in delay of treatment, complications and a prolonged hospitalization.