Archive of Old Cases
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- Archive of Old Cases
- 2009
Case No : 634 Date 2009-12-20
- Courtesy of Hye Sun Hwang, Chin A Yi / Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Age/Sex 42 / M
- Chief ComplaintChest discomfort S/P Diaphragmatic perforaton (20 years ago)
Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Gossypiboma
- Radiologic Findings
- Fig 1. Chest PA showed a large mass-like opacity in left lower hemithorax.
Fig 2-4. High-resolution CT images showed a large well-capsulated mass with internal whirl-like calcification. This mass showed a little enhancement. These findings are most compatible with gossypiboma. He underwent surgery, and was confirmed gossypiboma.
- Brief Review
- The term “gossypiboma” is derived from the Latin word “gossypium,” which means cotton, and the Swahili word “boma,”, which means place of concealment and refers to retained sponge in the surgical bed. Gossypiboma (textiloma or cottonoid) is an important complication of surgery, with an estimated incidence of one case per 1,500 surgeries. Retained sponge may induce an aseptic foreign body reaction with subsequent fibrosis and granuloma formation. Clinical and radiological appearances are variable, depending on the location and chronicity of the retained sponge. Two frequent sites of intrathoracic gossypiboma are the pleural and pericardial cavities.
Characteristic CT features of abdominal gossypibomas include a spongiform appearance with gas bubbles ; low-density mass with a thin enhancing capsule; and calcifications deposited along the network architecture of a surgical sponge. On the other hand, a sponge left within the pleural space shows no gas lucencies due to resorption of the air by the pleura.
Magnetic resonance features of intrathoracic gossypiboma have been described. They may appear as a pseudocystic mass containing a movable body or a mass having low signal intensity on T2 weighted images.
- References
- 1. Rachna Madan et al. Intrathoracic Gossypiboma AJR 2007(8);189:W90-W91
2. Suwatanapongched T el al Intrathoracic Gossypiboma: radiologic and CT findings BJR 2005(9);78;851-853
- Keywords
- Pleura, Iatrogenic lung disease, Postoperative complication,
No. of Applicants : 88
- ▶ Correct Answer : 53/88, 60.2%
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- - Asan Medical Center , Korea (South) Seong Yun Kim
- - Goa Medical College , India Paresh Desai
- - Osaka University , Japan Osamu Honda
- - Oita University, Faculty of Medicine , Japan Fumito Okada
- - Shiga University of Medical Science , Japan Norihisa Nitta
- - Seoul National University Hospital , Korea (South) Sang Min Lee
- - Samsung Medical Center , Korea (South) Sang Yu Nam
- - Hangang Sacred Heart Hospital , Korea (South) Eil Seong Lee
- - SMG-SNUH boramae medical center , Korea (South) Kwang Nam Jin
- - University of British Columbia , Canada Amr Ajlan
- - Seoul National University Hospital , Korea (South) JUNG KIM
- - POPOVO HOSPITAL , Bulgaria VLADISLAV RUSINOV
- - Shinchon Severance Hospital , Korea (South) Ho-Joon Lee
- - Yonsei university Shinchon Severance hospital , Korea (South) Na-young Shin
- - CHUV , Switzerland ANNE-SOPHIE KNOEPFLI
- - PingTung Christian Hospital ,China Medical University ,Taiwan,R.O.C. , Taiwan Jun Jun Yeh
- - EWHA WOMANS MOKDONG UNIVERSITY HOSPITAL , Korea (South) YOOKYUNG KIM
- - SMC , Korea (South) Jihoon Cha
- - Kang buk samsung hospital, department of radiology , Korea (South) Hyojin Lim
- - hospital Sao Paulo , Brazil israel missrie
- - Uzunkopru Devlet Hastanesi , Turkey Armagan Sarac
- - Assam Medical College , India Karunakaran M
- - EKH-Berlin , Germany Michael Weber
- - H�el-Dieu Montreal , Canada nicolas gautier
- - CHRU lille , France manuel toledano
- - CHU Grenoble , France Fabrice Bing
- - Univ. of Miami/Jackson Memorial , United States mantosh rattan
- - Saga University , Japan Ryoko Egashira
- - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
- - Hospital M� de Deus , Brazil Thiago Bento da Silva
- - Teleradiology solutions , India harish bhambore
- - Armed Force Capital Hospital , Korea (South) Dae Kun Oh
- - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
- - Dongguk University International Hospital , Korea (South) Ah-young Kim
- - Hospital of Inha university , Korea (South) Bongwan Noh
- - Samsung Medical Center , Korea (South) Eun Kim
- - KING KHALID UNIVERSITY HOSPITAL , Saudi Arabia Elbagir Nasser
- - KING KHALID UNIVERSITY HOSPITAL,RIYADH , Saudi Arabia NABIL GHALEB
- - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
- - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
- - IRSA , France jean-luc BIGOT
- - IRSA La Rochelle France , France Denis Chabassiere
- - Hospital Sotiria, Athens, Greece , Greece Vasilios Tzilas
- - McGill University Health Center , Canada Alexandre Semionov
- - chp st martin , France Mariotte benoit
- - Vital Imaging Centre, Mumbai,India , India Ganesh Agrawal
- - All India Institute of medical sciences , India Justin Moses
- - Seoul Nationial University Bundang Hospital , Korea (South) Hee Seok Choi
- - Bundang CHA hospital , Korea (South) Jung Jin Young
- - Beaulieu clinic Geneva , Switzerland gilles GENIN
- - UZ GASTHUISBERG , Belgium Johan COOLEN
- - care hospital , India Chary D
- - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
- ▶ Correct Answer as Differential Diagnosis : 3/88, 3.4%
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- - SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OKUBO
- - Ondokuz Mayis University , Turkey Cetin Celenk
- - All India Institute of Medical Sciences , India Ashish Gupta
- ▶ Semi-Correct Answer : 1/88, 1.1%
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- - HIA Legouest , France Alban Gervaise
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