Jejunal Gossypiboma Mimicking a Gastrointestinal Stromal Tumor: A Case of a Rare Iatrogenic Complication and Review of the Literature

Abstract

The term "gossypiboma" or "textiloma" is used to describe a mass of retained cotton matrix and the surrounding inflammatory response inside a body cavity following surgical intervention. The precise incidence of this phenomenon is uncertain, as cases are frequently underreported due to concerns related to medical malpractice. This rare complication poses a diagnostic dilemma due to the non-specific clinical and radiological features, which can result in significant morbidity and mortality. While diagnosis of this condition has been reported through various imaging modalities such as abdominal ultrasound and computed tomography, there are instances where cases do not present with typical findings, which can make it tough to make a preoperative diagnosis. The differential diagnosis from submucosal tumors of the gastrointestinal tract becomes challenging, particularly when the tumors are in contact with the gastrointestinal tract. It is possible that patients may be incorrectly informed that masses may be malignant, which could result in unnecessary extirpative surgery. In some cases, the diagnosis is discovered postoperatively. This case report presents a case of a 42-year-old woman who was initially suspected of having a gastrointestinal stromal tumor based on radiological findings. However, the patient was ultimately diagnosed with a gossypiboma following surgical intervention. A gross examination of the surgical specimen revealed that a gauze left over from a cesarean section performed nearly 20 years ago was the source of the gossypiboma. It is therefore evident that meticulous counting of surgical instruments and materials is crucial for patient safety and optimal outcomes.