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Gossypiboma is a unique postoperative complication characterized by the presence of a surgical sponge after surgery. This condition is seldom encountered. Owing to its serious medicolegal implications it remains underreported leading to a blurred clinical spectrum. This fact is also depicted in our case which presents an array of nonspecific symptoms painting a picture of possible malignancy. The case highlights the need for strict adherence to surgical protocols to avoid such instances of clinical negligence. Furthermore, our report provides the medical community with apt data to promptly diagnose such cases. A 40-year-old Asian hypertensive and diabetic female with a history of total hysterectomy presented with a 7-month history of progressive abdominal swelling, vomiting, and weight loss. The initial clinical presentation pointed to possible malignancies but subsequently revealed a 16 × 4 × 6 cm gossypiboma near the ileocecal junction. Following the removal and resection of 2.5 feet of the ileum, the patient underwent a right hemicolectomy, ileostomy, and colostomy. The postoperative recovery was uneventful, and the patient was discharged in stable condition. This case reiterates the importance of adhering to established surgical protocols and how minor negligence can have devastating and horrid effects. This case highlights the need for the fusion of medicine with technology< which prompts the use of innovations such as RFID-tagged sponges and electronic counting to minimize human error. Increased awareness and reporting of gossypibomas will aid in their timely diagnosis and management, ultimately reducing patient morbidity and associated legal challenges.

Mulugeta Taeme Gebretsion,1 Tilahun Sisay Alemu,2 Yimam Ali Mergiyaw1 1Department of Surgery, School of Medicine, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia; 2Surgery Department, Kemisse General Hospital, Kemisse, EthiopiaCorrespondence: Mulugeta Taeme Gebretsion, Department of Surgery, School of Medicine, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia, Tel +251904690867, Email mullerab1988@gmail.comIntroduction: Gossypiboma is the accidental retention of surgical gauze with inflammatory reaction in the body cavity after surgical procedures. It is an uncommon but preventable surgical mistake. This serious medical condition could have a substantial impact on morbidity and mortality as well as medico-legal issues.Case Report: We present here a case of a 30-year-old female referred to our surgical outpatient department with progressive lower abdominal swelling, pain, and low-grade fever of 4 months’ duration after she had undergone cesarean section 6 months back at the primary hospital. On physical examination, she was tachycardic and had a 15× 15 cm firm, mobile, non-tender, infra-umbilical abdominal mass. Abdominal ultrasound suggested possible gossypiboma, which was confirmed after exploratory laparotomy.Discussion: Any type of surgery can be a reason for retained surgical gauze, but its incidence can be significantly reduced if surgical checklists are used seriously and routinely in every patient. A strong index of suspicion continues to be crucial in the diagnosis of surgical gauze retention, particularly when a patient has experienced an unexplained bad course following surgery.Conclusion: : In patients who present with palpable abdominal mass and a history of previous abdominal surgical operations, the diagnosis of gossypiboma should be included in the differential diagnosis. Prevention of retained surgical items is the collective responsibility of the surgical team, the nursing team, and operation theatre technicians. Furthermore, strict measures should be implemented to avoid it.Keywords: case report, gossypiboma, retained foreign body, abdominal sponge, abdominal mass

Introduction: Gossypiboma is the accidental retention of surgical gauze with inflammatory reaction in the body cavity after surgical procedures. It is an uncommon but preventable surgical mistake. This serious medical condition could have a substantial impact on morbidity and mortality as well as medico-legal issues. Case Report: We present here a case of a 30-year-old female referred to our surgical outpatient department with progressive lower abdominal swelling, pain, and low-grade fever of 4 months' duration after she had undergone cesarean section 6 months back at the primary hospital. On physical examination, she was tachycardic and had a 15× 15 cm firm, mobile, non-tender, infra-umbilical abdominal mass. Abdominal ultrasound suggested possible gossypiboma, which was confirmed after exploratory laparotomy. Discussion: Any type of surgery can be a reason for retained surgical gauze, but its incidence can be significantly reduced if surgical checklists are used seriously and routinely in every patient. A strong index of suspicion continues to be crucial in the diagnosis of surgical gauze retention, particularly when a patient has experienced an unexplained bad course following surgery. Conclusion: : In patients who present with palpable abdominal mass and a history of previous abdominal surgical operations, the diagnosis of gossypiboma should be included in the differential diagnosis. Prevention of retained surgical items is the collective responsibility of the surgical team, the nursing team, and operation theatre technicians. Furthermore, strict measures should be implemented to avoid it. [ABSTRACT FROM AUTHOR]

BackgroundEndoscopic retrograde cholangiopancreatography is a common procedure performed for choledocholithiasis and gallstone pancreatitis. Although a relatively low risk procedure, it is not without its complications. Cases of impacted Dormia baskets during stone retrieval have been reported, but these are usually retrieved surgically during the same setting.Case summaryA 40-year-old man presented to our hospital with an episode of epigastric pain and discomfort. He has a prior background of recurrent episodes of pancreatitis of which he underwent prior endoscopic therapy in his home country. Initial investigations revealed a metallic object seen on abdominal x-ray, computer tomographic scan of the abdomen and pelvis, and magnetic resonance imaging of the pancreas. Further evaluation was done with endoscopy, which revealed a retained stone extraction basket from a previous endoscopic retrograde pancreatography, resulting in recurrent episodes of acute chronic pancreatitis. Although the retained foreign body was removed, he subsequently developed further complications of portal vein thrombosis as a result of recurrent acute chronic pancreatitis, which required anticoagulation.ConclusionThis case highlights the importance of retrieving any foreign body from the pancreas, especially on the head, to prevent the development of further complications.

Background Penetrating spinal cord injury (PSCI) with retained foreign bodies (RFB) is rarely observed in clinics and may result in a complete or incomplete neurological deficit. This study was performed to appraise the treatment effect of laminectomy for PSCI with RFB. Case Presentation This study presented three patients referred to a tertiary hospital between August 2011 and October 2018 due to PSCI with RFB and receiving laminectomy. The first patient was a 25‐year‐old female with a butcher's knife piercing the T9 lamina and T10 vertebral body obliquely; the second was a 49‐year‐old male who suffered a perforating wound of the cervical spinal canal and injury of vertebral artery from foreign glass, while the third was a 60‐year‐old male with a wooden stick penetrating stomach and terminating in the L1 lamina. The first and second patients immediately underwent laminectomy for debridement and removal of RFB, while the third received two‐staged operations to remove the retained stick thoroughly. Unfortunately cases 1 and 3 eventually resulted in total paralysis and case 2 revealed no improvement in myodynamia. Then, Medline/PubMed, Embase and the Cochrane Library were systematically searched, and 23 articles involving 25 additional cases with this kind of injury were included for analysis. Conclusions The optimal treatment strategy for penetrating spinal cord injury with retained foreign bodies remains challenging and should be assessed case‐by‐case. If possible, surgical removal of foreign bodies by laminectomy is preferred immediately to prevent delayed presentation and persistent contamination. Meanwhile, a multidisciplinary team is needed to address concomitant injuries.

Foreign bodies (FBs) are a relatively common reason for admission to the emergency department, with subacutely embedded FBs presenting a diagnostic challenge to physicians. Retained FBs may cause the patient harm and result in litigation when missed. Diagnostic imaging is a powerful tool for localization of FBs and a physician's choice of modality should reflect its anticipated composition. This case report pertains to a 2-year-old boy with a glass shard embedded in his retro auricular scalp who presented with a painful subcutaneous lesion months after an overlying laceration repair at an outside emergency room. The attending neurosurgeon was able to identify a glass shard both on physical examination and axial T2-weighted MRI. Surgical exploration resulted in the removal of a 1-cm square glass shard. Key to the diagnostic potential of imaging is knowledge of a patient's relevant medical history and the composition of the suspected FB. Herein, we describe imaging modalities and their utility in the context of retained glass FBs.

We present a case of delayed diagnosis of retained glass foreign body in the inguinal region of a child using ultrasonography following penetrating trauma to the upper thigh. The foreign body had traversed significantly by the time of diagnosis, from the medial upper thigh to the inguinal region at the level of the inguinal ligament. Ultrasound can be an effective initial imaging modality for the diagnosis of foreign bodies in children, allowing the potential to reduce ionizing radiation exposure.

Textiloma is a rare surgical complication. The location in the renal compartment is exceptional. The diagnosis can be difficult due to its rarity and the absence of clinical signs. The best treatment remains preventive by carefully counting the compresses and the operating fields at the beginning and end of the procedure. We present a case report of a 71-year-old female patient with a high blood pressure under treatment. In this history, we noted a right nephrectomy by a lombotomy 6 years ago indicated for a mute kidney on a pyelo-ureteral junction syndrome and a drainage of a suppuration of this renal compartment a year after surgery. The patient was diagnosed with purulent discharge through the lombotomy site associated with lower back pain that had been present for 4 years. The patient then underwent an uro-CT scan which showed an oval formation of the right renal compartment suggestive of a textiloma. An exploratory right lombotomy was performed. And then the wetraction of the compresses followed by washing and closing had been done. The postoperative course was simple. The location in the renal compartment is exceptional. These may include compresses, surgical gauzes, sponges, cotton pads, etc. The inflammation caused by this foreign body will be responsible for an abscess in the event of infection. An evolution towards chronicity follows as long as the foreign body persists. Diagnosis and reoperation are often made during the same hospitalization period. Early imaging will help to make early diagnosis avoiding diagnostic wandering. The diagnosis was made late in our observation. However, the diagnosis can be difficult due to its rarity and the absence of clinical signs. Textiloma is a rare surgical complication. Renal localization, although rare, is "exceptional" of consequence. The best treatment remains preventive by carefully counting the compresses and the operating fields at the beginning and end of the procedure. • Renal localization, although rare, is "exceptional" of consequence. • Questionnaire remains the pillar of diagnosis because the clinical and radiological manifestations are not specific. • Early imaging will help to make early diagnosis avoiding diagnostic wandering. • The surgical procedure is, however, very laborious in advanced stages due to fibrosis and adhesions resulting from the inflammatory process [ABSTRACT FROM AUTHOR]

Background: Penetrating spinal cord injury (PSCI) with retained foreign bodies (RFB) is rarely observed in clinics and may result in a complete or incomplete neurological deficit. This study was performed to appraise the treatment effect of laminectomy for PSCI with RFB. Case Presentation: This study presented three patients referred to a tertiary hospital between August 2011 and October 2018 due to PSCI with RFB and receiving laminectomy. The first patient was a 25‐year‐old female with a butcher's knife piercing the T9 lamina and T10 vertebral body obliquely; the second was a 49‐year‐old male who suffered a perforating wound of the cervical spinal canal and injury of vertebral artery from foreign glass, while the third was a 60‐year‐old male with a wooden stick penetrating stomach and terminating in the L1 lamina. The first and second patients immediately underwent laminectomy for debridement and removal of RFB, while the third received two‐staged operations to remove the retained stick thoroughly. Unfortunately cases 1 and 3 eventually resulted in total paralysis and case 2 revealed no improvement in myodynamia. Then, Medline/PubMed, Embase and the Cochrane Library were systematically searched, and 23 articles involving 25 additional cases with this kind of injury were included for analysis. Conclusions: The optimal treatment strategy for penetrating spinal cord injury with retained foreign bodies remains challenging and should be assessed case‐by‐case. If possible, surgical removal of foreign bodies by laminectomy is preferred immediately to prevent delayed presentation and persistent contamination. Meanwhile, a multidisciplinary team is needed to address concomitant injuries. [ABSTRACT FROM AUTHOR]

Management of retained trans-anal foreign bodies is yet to be standardized. We present a case of how a retained trans-anal colonic body spray can affect the anal sphincter and its effect on management. A male adult presented with a retained trans-anal body spray can in the colon and a weakened anal sphincter. A plain abdominal X-ray and colonoscopy confirmed the diagnosis. After a failed endoscopic removal, a non-operative manual removal was done. Sphincter tone improved 3 days later. The article describes anal sphincter weakness, patient categorization, and non-operative management of the retained colonic foreign body. [ABSTRACT FROM AUTHOR]

This report discusses a significant complication following a hysterectomy performed in Mexico on a 46-year-old woman who developed an intra-abdominal abscess due to a retained surgical towel - a severe but rare surgical error. Initially, her post-surgical symptoms, such as abdominal pain, fever, and malaise, were dismissed by her surgeon in Mexico as typical recovery effects. However, as her condition worsened, she sought emergency care in Arizona. A CT scan revealed a substantial abscess in her abdomen, identified by a radiodense ribbon indicating the forgotten surgical towel. Emergency surgery was required to remove the towel and treat the abscess, further complicated by the presence of a multi-drug-resistant organism. This case underscores the importance of strict adherence to surgical safety protocols, the risks of seeking medical procedures abroad, and the critical need for thorough postoperative monitoring and clear communication between patients and healthcare providers., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. 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 influenced the submitted work., (Copyright © 2024, Judd et al.)

Paraspinal textilomas are dreaded complications of spinal surgery and rarely reported in view of the medico-legal problems they may create. As many of them are asymptomatic and most are unreported, their true incidence is unknown. They must be kept in mind when re-operating for any mass lesion seen on magnetic resonance imaging in the vicinity of a previously operated spine. We present the case of a 40-year-old man found to have a textiloma as a result of a previous surgery, describe his imaging and histological findings, discuss the causes that might lead to the same, and enumerate preventive strategies to avoid such a complication. [ABSTRACT FROM AUTHOR]

Background: Nonmissile penetrating spine injury (NMPSI) represents a small percent of spinal cord injuries (SCIs), estimated at 0.8% in Western countries. Regarding the causes, an NMPSI injury caused by a screwdriver is rare. This study reports a case of a retained double-headed screwdriver in a 37-year-old man who sustained a stab injury to the back of the neck, leaving the patient with a C4 Brown-Sequard syndrome (BSS). We discuss the intricacies of the surgical management of such cases with a literature review. Methods: PubMed database was searched by the following combined formula of medical subjects headings, (MESH) terms, and keywords: (((SCIs [MeSH Terms]) OR (nmpsi [Other Term]) OR (nonmissile penetrating spinal injury [Other Term]) OR (nonmissile penetrating spinal injury [Other Term])) AND (BSS [MeSH Terms])) OR (BSS [MeSH Terms]). Results: A total of 338 results were found; 258 were case reports. After excluding nonrelated cases, 16 cases were found of BSS induced by spinal cord injury by a retained object. The male-to-female ratio in these cases is 11:5, and ages ranged from 11 to 72. The causes of spinal cord injury included screwdrivers in three cases, knives in five cases, and glass in three cases. The extracted data were analyzed. Conclusion: Screwdriver stabs causing cervical SCIs are extremely rare. This is the first case from Iraq where the assault device is retained in situ at the time of presentation. Such cases should be managed immediately to carefully withdraw the object under direct vision and prevent further neurological deterioration. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: Online educational modules can augment radiology learning by creating opportunities to interact with images in more dynamic ways than with static presentation of images in lectures or journal articles. Building these modules on an online survey platform allows for quantitative assessment and learner feedback, without requiring programming knowledge or need for new website creation.Materials and Methods: Interactive online tutorials were built on a web-based survey platform (Qualtrics, Provo, Utah) accessible by computer or mobile device to teach radiology imaging findings of selected high-morbidity diagnoses. Topics included congenital-type internal hernias (module 1), acute appendicitis in the pregnant patient (module 2), and unintentionally retained surgical instruments (RSI; module 3). Modules consisted of pretest, educational module, and post-test components. For modules 1 and 2, graphics interchange formats were utilized to show CT and MRI image stacks for the diagnosis of congenital-type internal hernias and acute appendicitis in pregnant patients, respectively. For module 3, the "Heat Map" format was chosen to showcase intraoperative radiograph cases, which allowed participants to click on the potential RSI in the image. Pre- and post-test scores were evaluated. To determine statistical significance, an alpha level of 0.05 was utilized.Results: Module 1 (Internal Hernia): Twenty-one radiology trainees completed the module. The mean pretest score was 3.66 (±1.13) points out of a total 6 possible points (61%), compared to 4.52 (±1.03) points on the post-test (75%). This was a statistically significant increase on the post-test of 0.87 points (95% CI [confidence interval] 0.36, 1.38), t(20) = 3.53, p= 0.002. Module 2 (MR Appendicitis): Seventeen radiology trainees completed the module. The mean pretest score was 3.18 (±1.42) points out of a total 6 possible points (53%), compared to 5.12 (±0.86) points on the post-test (85%). This was a statistically significant increase on the post-test of 1.94 points (95% CI 1.12, 2.76), t(16) = 5.00, p< 0.001. Module 3 (RSI): One hundred seven participants completed the module. The mean pretest score was 3.60 (±1.53) points out of a total 6 possible points (60%), compared to 4.54 (±1.36) points on the post-test (76%). This was a statistically significant increase on the post-test of 0.94 points (95% CI 0.67, 1.21), t(106) = 6.84, p< 0.001.Conclusion: An online survey platform can be used to build interactive education modules. Post-test scores significantly improved from pretest scores with these educational modules. [ABSTRACT FROM AUTHOR]

The investigation of embedded soft tissue foreign bodies relies heavily on radiological imaging. The prompt identification of these objects is critical as retained foreign bodies may lead to serious infection or chronic debilitating pain depending on anatomical location. In this report, we present a case of a radiographically occult traumatically implanted foreign body in a 15-year-old female after a high-speed motor vehicle accident. Initial computed tomography (CT) scan was unremarkable and exploration under anesthesia demonstrated no other significant findings, yet the patient continued to suffer severe refractory radicular pain with marked limitation of daily function. It was not until 12 weeks after the accident that a magnetic resonance image (MRI) of the pelvis revealed a deep sinus tract with central low magnetic resonance (MR) signal, raising suspicion for a retained foreign body. A 10-centimeter plastic foreign body extending from the patient's coccyx to the sciatic foramen was identified and surgically removed resulting in immediate symptom relief. This case illustrates that the detection of a retained foreign body is not always straightforward and multiple imaging modalities may be necessary for accurate diagnosis. We also discuss the most appropriate diagnostic imaging algorithm when a foreign body of the musculoskeletal system is suspected.

Purpose: To report a case of retained anterior chamber graphite foreign body with subsequent inflammation 20 years later. Observations: A 29-year-old female who presented with first episode of acute blurring of vision and eye redness was noted to have a retained intraocular graphite foreign body in her anterior chamber. She recalled being accidently hit by a mechanical pencil 20 years ago. Conclusions and importance: Retained intraocular graphite foreign bodies are inert and generally do not cause inflammation. This is the longest reported duration of retained anterior chamber graphite foreign body that developed subsequent inflammation and corneal endothelial damage only 20 years later.

Abstract We describe a case in which retained wires from a continuous glucose monitor were removed from the abdominal wall and peritoneum of a 6‐year‐old boy. We highlight a concern for continuous glucose monitor use in children and discuss surgical techniques used to retrieve tiny, mobile objects from complex body cavities.

Study Design Retrospective study. Purpose Missing cottonoids during and after spinal surgery is a persistent problem and account for the most commonly retained surgical instruments (RSIs) noticed during a final cottonoid count. The aim of this study was to enumerate risk factors and describe the sequence to look out for misplaced cottonoids during spinal surgery and provide an algorithm for resolving the problem. Overview of Literature There are only a few case reports on RSIs among various surgical branches. The data is inconclusive and there is little evidence in the literature that relates to spinal surgery. Methods This retrospective study was conducted at Indian Spinal Injuries Centre. The data was collected from hospital records ranging from January 2013 to December 2017. The surgical cases in which cottonoid counts were inconsistent during or after the procedure were included in the study. The case files along with operating theater records were thoroughly screened for selecting those in which there was confirmed evidence of such an event. Results There were 7,059 spinal surgeries performed during the study period. Fifteen cases of miscounts were recorded with an incidence of one in every 471 cases. Cottonoids were most commonly lost under the shoes of the surgeon or assistants. In two instances, cottonoids were found in the surgical field and trapped in the interbody cage site. Based on these locations, a systematic search algorithm was created Conclusions This study enumerates RSI risk factors in spinal surgical procedures and describes steps that can be followed to account for any missing cottonoids. The incidence of missing cottonoids can be decreased using a goal-oriented approach and ensuring that surgical teams work in collaboration.

Intestinal malrotation in neonates is well known with incidence of 1:500 and symptomatic incidence 1:6000 births. Duodenal web as a cause of intestinal obstruction is less common with incidence of 1:10000–1:40000. Intestinal obstruction due to duodenal web associated with malrotation is very rare and only few case reports published in the literature. In this report we present a case of a 2.5 year old female child with duodenal obstruction due to concurrent duodenal web and malrotation and discussed its management.

Female sexual pain (FSP) is a disorder that can greatly affect women’s health, relationships, work productivity, and quality of life. FSP is characterized by genital pain just before, during, or after sexual intercourse. FSP may depend on many possible causes ranging from anatomical alterations to psychological or social issues. The authors describe a case of a 54-year-old woman, suffering from female sexual pain for nine years. An abdominal echography of the patient was performed and it revealed a retained intra-abdominal foreign body. It was forgotten during a hysterectomy by the surgeon 9 years prior. In cases of injury and/or death caused by a foreign body, the main surgeon and his assistant/subordinate are punishable by law for engaging in markedly imprudent and/or negligent conduct. This conduct includes not scrupulously double-checking the surgical site before its closure to highlight forgotten foreign bodies. Either the circulator nurse or the theatre nurse may be considered liable for this case of malpractice.

Background: The presence of retained foreign bodies in the spinal canal has been reported in the literature. They are attributed to retained pieces of medical equipment after surgery, or, following trauma, to residual bullets, glass fragments, or knife blades. Although some retained materials do not cause any neurological deficits in the short run, others may become symptomatic months later. Case Description: A 2-year-old male presented with a history of intermittent fever and mild lower extremity weakness. Notably, the original infectious workup was negative. However, a noncontrast CT scan later documented a needle-shaped foreign body in the spinal canal at the T10 level. During the T10 laminectomy, a needle (i.e. from a medical syringe) was removed, the patient remained neurologically intact. The foreign body turned out to be a medical syringe needle tip. Conclusion: A 2-year-old male presented with fevers and mild lower extremity weakness attributed to an intraspinal needle tip found utilizing CT at the T10 level. T10 laminectomy allowed for removal of a small needle tip. This shows the importance of removing retained spinal foreign bodies to avoid further/future neurological injury, and/or the potential risks/complications of foreign body migration/sequestration. [ABSTRACT FROM AUTHOR]

Foreign bodies are encountered relatively often within the practice of general surgery. We present a unique case of a rubber, self-retaining, radiopaque "mushroom-tip" Malecot tube placed for fistula drainage control due to an enterocutaneous fistula (ECF) that became a gastrointestinal foreign body.  A 24-year-old male presented in shock with gunshot wounds to his right chest and right upper abdomen to a Level I trauma center. He required a prolonged hospital stay with additional urological and thoracic procedures and an interventional radiology procedure for hepatic pseudoaneurysm and subsequently developed an ECF. The patient was discharged to a rehabilitation facility with a wound management system (WMS) for ECF drainage but returned to the clinic with chemical burns and skin excoriation due to poorly controlled output and suboptimal WMS fit. A better fitting WMS was employed and a 20-French Malecot catheter was placed to assist with drainage control. The patient later returned with abdominal pain reporting the Malecot advanced forward spontaneously and was not externally visible. CT scan revealed the Malecot across the prior ileocolic anastomosis. After considering potential treatment options, we initially proceeded with aggressive bowel stimulation, and saline enemas hoping the tube would pass through his colostomy. He was discharged and the catheter passed at home a few days later via the stoma. Gastroenterological literature recommends invasive management for sharp, corrosive, or elongated foreign bodies exceeding 6cm in length. This unusual case demonstrates a 30-centimeter (cm) blunt object passing through the small bowel and colon in the absence of an ileocecal valve., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, O'Quinn et al.)

Introduction and Importance: Foreign bodies in the liver are uncommon but can lead to severe conditions like liver abscess and sepsis. They typically enter through direct penetration, migration from the gastrointestinal tract, or through the blood. Common foreign objects include metal pins, or sewing needles swallowed accidentally., Case Presentation: A 25-year-old male presented to our OPD with pain over the right abdomen with a prior history of projectile injury causing laceration over the right anterior abdomen with primary suturing. On radiological investigation, a retained foreign body was revealed. The metallic foreign body was embedded in the liver for 5 months. Removal of the foreign body was performed without any complications., Clinical Discussion: Intrahepatic foreign bodies (FBs) in the liver can result from penetrating injuries, iatrogenic causes, or ingestion, particularly in children. Clinical presentations vary, and complications such as abscess formation may occur. Diagnosis involves imaging modalities like X-rays, ultrasonography, and computed tomography (CT) scans. The presented case highlights the importance of meticulous follow-up, as chronic pain manifested despite conservative management. The management of intrahepatic FBs depends on factors like size, location, and symptoms, with conservative approaches for stable patients. Surgical removal remains the mainstay of the treatment. Long-term monitoring is crucial to detect potential complications, and imaging studies play a key role in regular follow-up., Conclusion: Hepatic foreign bodies are rare, and symptoms vary based on size, type, and location, ranging from asymptomatic to complications such as abscess formation. Surgical removal is the main treatment, but in cases of noncomplicated hepatic foreign bodies, close follow-up is necessary., Competing Interests: The authors have no conflicts of interest to declare.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Penetrating chest trauma is rarely seen in childhood. Following penetrative trauma various foreign objects may be detected as embedded in the tissues. A precise and prompt diagnosis together with an appropriate surgical management is paramount in these cases for a good prognosis. Here we present 2 cases with 2 different foreign bodies embedded in thoracic wall following different penetrating thoracic traumas. The purpose this report to critique the properties and handling of penetrative chest wall trauma in children with regard to post-traumatic retained FBs in thoracic wall and the topic is discussed under the light of relevant literature. [ABSTRACT FROM AUTHOR]

We describe a case in which retained wires from a continuous glucose monitor were removed from the abdominal wall and peritoneum of a 6‐year‐old boy. We highlight a concern for continuous glucose monitor use in children and discuss surgical techniques used to retrieve tiny, mobile objects from complex body cavities. [ABSTRACT FROM AUTHOR]

Study Design: Retrospective study. Purpose: Missing cottonoids during and after spinal surgery is a persistent problem and account for the most commonly retained surgical instruments (RSIs) noticed during a final cottonoid count. The aim of this study was to enumerate risk factors and describe the sequence to look out for misplaced cottonoids during spinal surgery and provide an algorithm for resolving the problem. Overview of Literature: There are only a few case reports on RSIs among various surgical branches. The data is inconclusive and there is little evidence in the literature that relates to spinal surgery. Methods: This retrospective study was conducted at Indian Spinal Injuries Centre. The data was collected from hospital records ranging from January 2013 to December 2017. The surgical cases in which cottonoid counts were inconsistent during or after the procedure were included in the study. The case files along with operating theater records were thoroughly screened for selecting those in which there was confirmed evidence of such an event. Results: There were 7,059 spinal surgeries performed during the study period. Fifteen cases of miscounts were recorded with an incidence of one in every 471 cases. Cottonoids were most commonly lost under the shoes of the surgeon or assistants. In two instances, cottonoids were found in the surgical field and trapped in the interbody cage site. Based on these locations, a systematic search algorithm was created. Conclusions: This study enumerates RSI risk factors in spinal surgical procedures and describes steps that can be followed to account for any missing cottonoids. The incidence of missing cottonoids can be decreased using a goal-oriented approach and ensuring that surgical teams work in collaboration. [ABSTRACT FROM AUTHOR]

Retained foreign bodies inside the soft tissue following penetrating injuries are common. Late onset of symptoms and complications are possible in these cases. In the present report, we present a case of late flexor digitorum profundus irritation and pseudotumour formation caused by a retained glass piece 10 years after the injury. Pseudotumour is formed by reaction to the retained material as an enlarged portion of tissue that resembles a tumour. The complaints were completely improved soon after removal of the foreign material. Retained soft tissue foreign bodies should be suspected in differential diagnosis of soft tissue masses. History of a penetrating trauma should be questioned persistently. The authors recommend the removal of retained foreign bodies with sharp edges to avoid further injury to the surrounding anatomical structures.

Retained foreign bodies in small bowel diverticula are a rare occurrence. Batteries and battery containing products can cause bowel perforation, and when retained in diverticula, retrieval methods may need to be considered. We present a novel case of a hearing aid powered by lithium battery getting stuck in a jejunal diverticulum, and outline an approach to retrieval. [ABSTRACT FROM AUTHOR]

Gossypiboma refers to inadvertently retained foreign objects after surgical operations. High body mass index and emergency surgery are risk factors of the condition. Presenting symptoms are usually non-specific and it may result in serious complications such as bowel obstruction. Removal can be attempted with endoscopic or surgical approaches depending on the site and presence of complications. This case highlights the need for considering gossypiboma in patients presenting with abdominal symptoms after recent abdominal surgery. Herein we report the case of a 30-year-old woman with abdominal pain two months after mini-gastric bypass surgery. Cross-sectional imaging showed a hyperdense area in the small bowel concerning for malignancy. However, upper endoscopy revealed a 10 χ 40 cm retained surgical gauze in the afferent loop that was successfully retrieved. Although rare, retained foreign body should be considered in the differential diagnosis of postoperative abdominal pain. [ABSTRACT FROM AUTHOR]

Duodenal atresia and web are common causes of intestinal obstruction in early infancy. Their incidence ranges between 1 in 10,000 to 1 in 40,000 live births. Unlike duodenal atresia which is diagnosed early, even antenatally; A web presents later depending on the size of the aperture in the web. It usually presents with bilious or non bilious vomiting. We present an unusual presentation of duodenal web in a three and a half years old boy who presented with a 12 months history of abdominal distension and vomiting every 2nd or 3rd day. Plain abdominal imaging showed radiopaque foreign bodies below the diaphragm. As the natural history for majority of ingested foreign bodies is natural passage; He was managed expectantly elsewhere. Eventually, 12 months later, the patient presented to our center where further investigation provided the diagnosis. He was treated surgically by excision of the web. Post operatively, TPN and a trans-anastomotic tube (TAT) were used until full recovery was achieved. A high index of suspicion is the key to reaching the true diagnosis in patients presenting after the neonatal period.

16 years old boy with childhood history of chronic respiratory symptoms requiring several admissions presented with recent worsening of symptoms. Chest x-ray showed left lower lobe collapse and flexible bronchoscopy revealed stenosis of left main bronchus. Foreign body was seen beyond the stenosis, which was removed after dilatation of narrowed bronchus under general anesthesia using rigid bronchoscopy. Patient′s father gave a history of aspiration of whistle 14 years ago, which had then been removed. Patient is now free of symptoms after removal of foreign body.

Retained fractured guidewire fragments are rarely encountered during percutaneous coronary intervention, but may cause serious morbidity. We present the case of an 85-year-old man who suffered from this complication. He was successfully treated by coronary stent without peri-procedure complications. Follow-up coronary angiography revealed no in-stent restenosis. Coronary interventionists should know how to manage this complication.

Background: Nonmissile penetrating spinal cord injury (NMPSCI) with a retained foreign body (RFB) is rare and usually results in permanent neurological deficits. In extremely rare cases, patients can present without significant neurological deficits despite an RFB that traverses the spinal canal. Given the rarity of these cases, a consensus has not yet been reached on optimal management. In a patient with an RFB and a neurologically normal clinical examination, the risk of open surgical exploration may outweigh the benefit and direct withdrawal may be a better option., Observations: A 10-year-old female suffered an NMPSCI to the thoracic spine with an RFB that bisected the spinal canal but remained neurologically intact. Direct withdrawal of the RFB was chosen instead of open surgical exploration, leading to an excellent clinical outcome. The literature was reviewed to find other examples of thoracic NMPSCI with RFB and neurologically normal examinations. Management strategies were compared., Lessons: For NMPSCI with RFB and without significant neurological deficits, direct withdrawal is a viable and possibly the best treatment option. The use of fast-acting anesthesia without intubation minimizes patient manipulation, speeds up recovery, and allows early assessment of neurological status after removal.

Gossypibomas remain a dreaded and unwanted complication of surgical practice. Despite significant interest and numerous guidelines, the number of reported cases remains sparse due to various factors, including potential legal implications. Herein, we review related data from India to ascertain if the problem is better or worse than that reported in world literature.~Purpose Of Review~Objective~A literature search was performed on PubMed and Google Scholar, to collect and analyze all case reports and case reviews regarding the condition in India.~Materials and Methods~Methods~On analysis of the results, there were 100 publications reporting a total of 126 events. The average patient age was 38.65 years. Average time to discovery was 1225.62 days. Forty-nine percent of reported cases were discovered within the 1 st year. The most common clinical features were pain (73.8%), palpable mass (47.6%), vomiting (35%), abdominal distention (26%), and fever (12.6%). Spontaneous expulsion of the gossypiboma was noted in five cases (3.96%). Transmural migration was seen in 36 cases (28.57%).~Results~Results~Despite advancements in surgical approaches and preventive measures, gossypibomas continue to be a cause of significant morbidity. A safe working culture, open communication, teamwork, and an accurate sponge count remain our best defence against this often unpredictable complication of surgery.~Conclusions~Conclusions [ABSTRACT FROM AUTHOR]

Introduction Retained surgical sponge or other items in patients’ bodies happens more frequently than is reported. Healthcare personnel can forget to remove textile material or instruments during complicated, extended, or emergency surgery. In addition, changes in the operating team can influence the occurrence of such errors. Presentation of case We present a case with a symptomatic gossypiboma nine years after a previous cesarean section. A 34-year-old woman was admitted to the emergency room having experienced abdominal pain and fever for the previous month. An abdominal computed tomography revealed an abscess in the lower abdomen. A laparotomy was performed, and a resection and block were carried out. A surgical sponge was extracted from an omental abscess. Discussion Surgical sponges are the most common foreign materials retained (70%) in the abdominal cavity because of their frequent usage and small size. Moreover, a blood-soaked sponge in a hemorrhagic abdomen can be difficult to distinguish from blood. Conclusion Whenever the accounting for material depends on humans, mistakes will continue to be committed. A falsely correct sponge count was reported in 71.42% of cases [14]; therefore, a new count system must be developed for post-surgical situations. [ABSTRACT FROM AUTHOR]