A Case Report of a Retained Gauze Sponge in the Abdomen with Massive Bleeding from the Rectum

Kenju Ko, Susumu Fujioka, Kenji Kato, Yuichi Machiki, Mizuo Hashimoto and Akira Ishikawa

Department of Surgery, Kiryu Kosei General Hospital

We report a case of a retained gauze sponge in the abdomen with massive bleeding because of penetration to the rectum 14 years after surgery. A 58-year-old woman was admitted to the hospital because of bloody stools. She had received hysterectomy for myoma of the uterus 14 years previously. After the present admission, colonoscopy and CT scanning revealed an extramural tumor of the rectum. The tumor compressed the rectum and penetrated through the rectal wall. Under a diagnosis of leiomyoma with rectal necrosis or retained gauze sponge, a low anterior resection was performed. At operation, the extramural tumor of the rectal wall was confirmed to be adherent to the surrounding tissues. From the resected material, the tumor was partially exposed to the mucosal surface and gauze was found from the tumor. Aside from this case, we found only three cases of retained gauze sponge penetrating to the intestine from the Japanese literature after 1965. Furthermore, our case was the only one to present with bloody stools.

Key words
retained surgical gauzes, penetration into the intestine, bloody stool

Reprint requests
Kenju Ko Department of Surgery, Kiryu Kosei General Hospital 6-3 Orihime-cho, Kiryu, 376-0024 JAPAN

Accepted
June 28, 2000

To read the PDF file you will need Abobe Reader installed on your computer.