1. Emergency Presentation of Abdominal Pain with Unusual Etiology.
- Author
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Naeem, Abdul, Aziz, Maria, Mir, Alia, Sial, Hamid, Shafiq, Muhammad Mudassir, and Arshad, Iram
- Subjects
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ABDOMINAL pain , *ETIOLOGY of diseases , *LYMPH nodes , *HOSPITAL emergency services , *ABDOMEN - Abstract
Abdominal pain has vast differentials and routine etiologies are diagnosed easily. The difficulty arises with an uncommon presentation. This is a case of 28 years old lady presenting to the emergency department of Holy Family Hospital, Rawalpindi with worsening abdominal pain, vomiting, and loose stools over 2 weeks. Abdominal examination and baseline laboratory workup (CBC, electrolytes, septic, renal, and liver profile) were inconclusive. Ultrasound of abdomen revealed matted gut loops with enlarged lymph nodes. CECT abdomen confirmed a non-differentiating tissue collection in the right iliac fossa. Later diagnosis of complicated gossybioma (retained gauze surrounded by fibrotic tissue with entero-enteric fistula and fecolith in appendix) was confirmed by laparoscopy that was surgically removed. Conclusion: Gossybioma is an infrequent but avoidable complication that needs to be considered by the surgeon meticulously especially by swab counting, avoiding staff change over during procedure, and considering in a follow-up visit. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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