GOSSYPIBOMA: GOSSYPIBOMA: ULTRASOUND FINDINGS and MDCT CORRELATIONSULTRASOUND FINDINGS and MDCT CORRELATIONS

HUNG THIEN NGUYEN, NHAN THANH NGUYEN VO, HAI THANH PHANHUNG THIEN NGUYEN, NHAN THANH NGUYEN VO, HAI THANH PHAN

MEDIC MEDICAL CENTER, HCMC, VIETNAMMEDIC MEDICAL CENTER, HCMC, VIETNAM

PURPOSEPURPOSE

Gossypiboma or textiloma may be Gossypiboma or textiloma may be disclosed incidentally by ultrasound in disclosed incidentally by ultrasound in routine check-up.routine check-up.

The aim of the present study was to The aim of the present study was to evaluate the findings of conventional evaluate the findings of conventional ultrasound in the detection of ultrasound in the detection of gossypiboma. gossypiboma.

METHODS and MATERIALSMETHODS and MATERIALS

All patients received conventional All patients received conventional ultrasound, and then MDCT to confirm the ultrasound, and then MDCT to confirm the ultrasound findings and rule out a ultrasound findings and rule out a malignant mass.malignant mass.

RESULTSRESULTS

From 1995 to 2011, there are 12 cases From 1995 to 2011, there are 12 cases which were detected by ultrasound and which were detected by ultrasound and later confirmed by MDCT and surgery. later confirmed by MDCT and surgery.

The time point to detect gossypiboma are The time point to detect gossypiboma are in range from one 1 month to 23 years in range from one 1 month to 23 years post-op.post-op.

Most of cases are in fibrinous stage and 3 Most of cases are in fibrinous stage and 3 cases in early stage.cases in early stage.

RESULTS (cont.)RESULTS (cont.)

Ultrasound findings of gossypiboma are Ultrasound findings of gossypiboma are cystic formation masses with echogenic cystic formation masses with echogenic structure, hypoechogenic contour and structure, hypoechogenic contour and strong posterior shadowing. strong posterior shadowing.

3 types: (1) echogenic mass with 3 types: (1) echogenic mass with "umbrella sign" (Dr  Hai Thanh Phan, "umbrella sign" (Dr  Hai Thanh Phan, 1988) ; (2) cystic mass encapsulates 1988) ; (2) cystic mass encapsulates striped structure inside; (3) non specified striped structure inside; (3) non specified hypoechoic or mixed mass.hypoechoic or mixed mass.

Gossypiboma post cesarian for 5 months

Gossypiboma post removed left kidney for 7 years

Gossypiboma post removing R.kidney stone for 13 years

Gossypiboma post op for 23 years

Gossypiboma post appendicectomy for 14 months

Gossypiboma post cesarian for 1 month

Gossipiboma post removing R. thyroid nodule for 8 months

DISCUSSIONSDISCUSSIONS

With one’s own skills and experiences, With one’s own skills and experiences, ultrasound is sensitive to detect gossypiboma ultrasound is sensitive to detect gossypiboma and can differentiate from a malignant mass. and can differentiate from a malignant mass.

Umbrella sign may help although that is not a Umbrella sign may help although that is not a specific finding in differentiating gossypiboma to specific finding in differentiating gossypiboma to fecalith, abscess and real tumor.fecalith, abscess and real tumor.

But MDCT (and MRI) play a valuable role in But MDCT (and MRI) play a valuable role in identification the textile structure of retained identification the textile structure of retained gauze in the abdomen. gauze in the abdomen.

CONCLUSIONSCONCLUSIONS

Ultrasound can be performed in the Ultrasound can be performed in the detection of gossypiboma with reliable detection of gossypiboma with reliable results, in regarding of the scar on the results, in regarding of the scar on the region of previous surgery. region of previous surgery.

Based on the clinical context, ultrasound Based on the clinical context, ultrasound may help avoid a misdiagnosis of an may help avoid a misdiagnosis of an intraabdominal malignant mass, abscess intraabdominal malignant mass, abscess and fecalith.and fecalith.

REFERENCESREFERENCES

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