Extraction of textile foreign bodies retained in the abdomen
Keywords:
Textiloma, foreign body, abdominal cavity, imaging studies, reoperation, medical errorAbstract
Unintational retention of foreign bodies inside the patient after surgery is a serious type of medical error. The most common remaining objects are gauze meshes called “textilomas”. The data on methods and features of abdominal textilomas elimination are limited and contradictory. There were identified 21 cases of abdominal textiloma. The following data were collected and assessed: gender and age of patients; type of primary surgery; preliminary diagnosis; time interval since the initial surgery; clinical manifestations; diagnostic approaches and studies results; methods of textiloma elimination; volume of repeated surgery, postoperative evolution. Among the patients, 15 (71.4%) were women and 6 (28.6%) were men, with a mean age of 36.5±3.1 years. The primary surgical procedure, in which textiloma was left in abdominal cavity, performed for obstetric and gynecological indications in 9 patients, and for surgical pathology – in 12. The time interval from the primary surgery to diagnosis of textiloma ranged from 1 day to 16 years (average 172.1±56.4 weeks). In addition to physical examination, for the diagnosis of abdominal textiloma were used radiography, ultrasonography and computer tomography. Elimination of textiloma required repeated surgical interventions in 95.2% of cases, and in 4 (19.0%) cases was accompanied by forced resection procedures. To remove the abdominal textiloma, most patients require a repeated laparotomy, the volume of which depends on duration and location of foreign body, as well as degree of involvement of neighboring organs.
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