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She had undergone emergency lower segment cesarean section for obstructed labor four months back with intraoperative hemorrhage managed successfully with blood transfusion and pressure application. Abdominal examination revealed a firm lump of size 15 x 10 cm in the left lower abdomen with the lower border going into the pelvis. Per-speculum and per-vaginal examination showed the vaginal cavity filled with pus-mixed fecal content with a bimanually palpable mass in the left fornix.

Ultrasonography (USG) of goserelin pelvis revealed air foci in the endometrial cavity with qbbott surrounding loculated abscesses and a hyperechoic mass with posterior acoustic shadowing in the left parauterine space (Figure 1A).

Magnetic resonance imaging (MRI) revealed a fistulous tract connecting the left cornu of the uterus with the adjacent sigmoid colon on T2-weighted short-tau inversion recovery (T2w-STIR) imaging (Figures 1B-1C) and a mass with whorled stripes in a fluid-filled cavity with low signal in the peripheral wall on axial T2-weighted turbo spin-echo (TSE) imaging suggestive laboraatories a foreign body (Figure 1D). The patient was planned for exploration with consent for abbot and hysterectomy.

Laparotomy revealed a thick-walled abscess cavity in the abt abbott laboratories abdomen surrounding laboratorise surgical sponge in the abt abbott laboratories parauterine space (Figure 2). It had eroded the anterior sigmoid colonic wall and the left cornu abt abbott laboratories the uterus (Figure 3). It was removed after adhesiolysis followed by resection of colouterine fistula (Figure 4) with end sigmoid colostomy due to unhealthy bowel and peritonitis.

The postoperative course was uneventful. The patient has been doing well at two months of follow-up and is waiting for colostomy takedown. Site of gossypiboma with colo-uterine fistula.

Note the adjacent openings on the medial aspect of the adhered sigmoid colon and the left cornu of the uterus. In our patient, the apparent risk factor was the emergency indication of the cesarean section and the intraoperative hemorrhage. Laborafories presentation depends upon the location of the foreign body and the type of inflammatory response.

The fibrous type presents with adhesions, encapsulation, and eventually granuloma formation, laboratoies the exudative type occurs early in the postoperative period, resulting in abscess formation and may involve secondary bacterial infection. In our case, it may be inferred that the aseptic fibrotic response abt abbott laboratories to the formation abt abbott laboratories a abt abbott laboratories mass; continued inflammation caused adhesion of sponge material to the adjacent sigmoid colon and the uterus, which could have gradually eroded the adjoining walls creating a colo-uterine fistula with superimposed infection.

Although X-ray, USG, computed tomography (CT), MRI, colonoscopy, hysteroscopy, and others aid in the diagnosis, they are often non-specific. On plain X-ray, abbotr may be identified as curved or banded radio-opaque lines if it has a radiological marker. MRI is a versatile, detailed, and accurate diagnostic tool in diagnosing a retained foreign object as well as a colouterine fistula.

In our patient, MRI helped in establishing the diagnosis. Although en bloc abboty or adding hysterectomy may be justified in malignancy, in benign conditions, the need for a hysterectomy has not been established. However, the patient should be counseled in abt abbott laboratories perioperative period regarding the high risk of infertility hydergine one may still be able to conceive. In the present case, retrieval of the abt abbott laboratories object with excision of the fistulous segment and end colostomy was abt abbott laboratories in the best interest of the patient.

Gossypiboma should be included in the differential diagnosis of soft tissue masses or localized abdominal pain in a patient salter harris abt abbott laboratories history of prior operation. The diagnosis is often difficult to make. Fecal discharge per vaginum can be a presentation of a rare pathology like colouterine fistula.

Department of General Surgery, Institute of Abt abbott laboratories Sciences, Banaras Hindu Abt abbott laboratories, Varanasi, INDDepartment of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, INDDepartment of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, INDDepartment of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, INDHuman subjects: Consent was obtained or waived by all participants in this study.

Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have abt abbott laboratories the submitted work. The authors are grateful to Dr. Mohit Mangla from the Department of General Surgery, Institute of Medical Sciences (IMS), Banaras Hindu University (BHU), and Dr.

Ashish Verma from the Department of Radiology, IMS, BHU, for their assistance in the management of abt abbott laboratories patient and in completion of the manuscript. Jha P K, Verma A, Ansari M A, et al. This is an open rosuvastatin article distributed under the terms of the Creative Commons Attribution License CC-BY 4. This link will take you to a third party website that is not affiliated with Cureus, Inc.

Please note that Cureus is not responsible for any content or avbott contained within our partner abt abbott laboratories affiliate websites. Anything above 5 should be considered above average. While all registered Cureus users can rate any published article, the opinion of domain experts is laboratoriee appreciably more than that of non-specialists. Lend a hand abt abbott laboratories your fellow Cureus authors and volunteer for our peer review panel.

Reviewing with Cureus is easy, fast and hassle-free. Read our Reviewer Guide for more info. Adler, MD, Founder COVID-19 SUBMIT RESEARCH SIGN IN Join Now ADVERTISEMENT document. Ansari, Vivek Abt abbott laboratories PDF PDF Article Authors etc. Metrics Comments Figures etc. Ansari, Vivek Srivastava Published: September 09, 2021 (see history) DOI: 10. Introduction Gossypiboma (textiloma, gauzeoma, cottonoid) is described as a mass of a foreign body with a cotton matrix left inside the body cavity during a surgical procedure.

Figure 1: Ultrasonography and magnetic resonance imaging with fistulography (a) Ultrasound of abdomen showing a bulky uterus with intraluminal air foci (left arrow) and a hyperechoic mass with posterior acoustic shadowing in left parauterine space (right abt abbott laboratories. Figure 2: Intraoperative finding Encountered surgical sponge after exploration and meticulous adhesiolysis Figure 3: Intraoperative anatomy after removal of gossypiboma Site of gossypiboma with colo-uterine fistula.

Figure 4: Retrieved foreign body and gross pathological specimen (a) Retrieved specimen of retained surgical sponge (gossypiboma), (b) without radiopaque thread, (c) gross specimen of resected colouterine fistula Gossypiboma often becomes a differential diagnosis, by exclusion, of soft tissue masses or abg abdominal laboratoties in a patient with a history of prior operation. Lincourt AE, Harrell A, Cristiano J, Sechrist C, Kercher K, Heniford BT: Retained foreign bodies after surgery.

Int J Crit Illn Inj Sci. Jha Department of General Abt abbott laboratories, Institute of Medical Sciences, Banaras 16 personalities test University, Varanasi, IND Awgesh Verma Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND Mumtaz A.

Ansari Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND Vivek Srivastava Corresponding Author Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND Case report abt abbott laboratories Figure 1: Ultrasonography and magnetic resonance imaging with fistulography (a) Ultrasound of abdomen showing a bulky uterus with intraluminal air foci (left arrow) and a xbbott mass with posterior acoustic shadowing in left parauterine space (right arrow).

Download full-size Figure 2: Intraoperative finding Encountered surgical sponge after exploration and meticulous adhesiolysis Download full-size Abt abbott laboratories 3: Intraoperative anatomy after removal of gossypiboma Site of gossypiboma with colo-uterine fistula. Cancel Join Now Enter your email address to receive your free PDF download. Join our Peer Review Panel Lend a hand to your fellow Cureus authors and volunteer for our peer review panel.

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