{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:11:13Z","timestamp":1792735873455,"version":"4.5.0"},"reference-count":56,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:00:00Z","timestamp":1692230400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Gossypiboma or textiloma is a rare medical situation that can complicate the favorable evolution of a surgical case, with repercussions for the patient\u2019s prognosis. The diagnosis can be difficult due to various clinical symptoms, the time elapsed since the surgical intervention, and the imaging often not being precise in detecting textilomas. Due to the medicolegal implications, the reporting of this event is inconsistent. We present a rare case of a 28-year-old woman who presented with vague pain in the left iliac fossa 11 months after an emergency cesarean hysterectomy was performed. The preoperative imaging examination identified the presence of a subhepatic mass with dimensions of 10 \u00d7 8 cm2 and another formation in the right iliac fossa with dimensions of 11 \u00d7 9 cm2. Exploratory laparotomy found the presence of a large subhepatic gossypiboma, intimately adherent to the hepatic angle of the colon and omentum and a second one adherent to the sigmoid colon, small intestine, and parietal peritoneum. The particularity of this case is given by the simultaneous presence of two textilomas with inconclusive evolution, which can make the differential diagnosis difficult to achieve. For a better assessment of the risk of occurrence of this pathology and the identification of a correct prevention strategy, we performed an extensive search and a review of all the articles published in the PubMed database, identifying 57 articles. In conclusion, emergency surgery increases the risk of this complication, and, as a result, prevention can be achieved by following existing protocols in the operating room.<\/jats:p>","DOI":"10.3390\/jcm12165353","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T10:47:02Z","timestamp":1692269222000},"page":"5353","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Gossypiboma, the Hidden Enemy of an Emergency Cesarean Hysterectomy\u2014Case Report and Review of the Literature"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8342-9819","authenticated-orcid":false,"given":"Valentin Nicolae","family":"Varlas","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania"},{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020956 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana Georgiana","family":"Bors","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3179-7350","authenticated-orcid":false,"given":"Bogdan","family":"Mastalier","sequence":"additional","affiliation":[{"name":"General Surgery Clinic, Colentina Clinical Hospital, 020125 Bucharest, Romania"},{"name":"General Surgery Department, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Balescu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ponderas Academic Hospital, 021188 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolae","family":"Bacalbasa","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica-Mihaela","family":"Cirstoiu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020956 Bucharest, Romania"},{"name":"Department of Obstetrics and Gynecology, University Emergency Hospital Bucharest, 050098 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,17]]},"reference":[{"key":"ref_1","first-page":"QR01","article-title":"A Case Series on Gossypiboma\u2014Varied Clinical Presentations and Their Management","volume":"9","author":"Chopra","year":"2015","journal-title":"J. Clin. Diagn. Res. JCDR"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/ACO.0b013e328324f82d","article-title":"Improving Safety in the Operating Room: A Systematic Literature Review of Retained Surgical Sponges","volume":"22","author":"Wan","year":"2009","journal-title":"Curr. Opin. Anaesthesiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1097\/00007611-198206000-00006","article-title":"Natural History of the Retained Surgical Sponge","volume":"75","author":"Hyslop","year":"1982","journal-title":"South. Med. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.jamcollsurg.2007.12.047","article-title":"Incidence and Characteristics of Potential and Actual Retained Foreign Object Events in Surgical Patients","volume":"207","author":"Cima","year":"2008","journal-title":"J. Am. Coll. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s00540-022-03127-7","article-title":"Characteristics of Retained Foreign Bodies and Near-Miss Events in the Operating Room: A Ten-Year Experience at One Institution","volume":"37","author":"Takahashi","year":"2023","journal-title":"J. Anesth."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1590\/0100-69912016001004","article-title":"Unintentionally Retained Foreign Bodies after Surgical Procedures. Analysis of 4547 Cases","volume":"43","author":"Birolini","year":"2016","journal-title":"Rev. Col\u00e9gio Bras. Cir."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"4775","DOI":"10.1177\/0300060518788247","article-title":"Retained Surgical Needle and Gauze after Cesarean Section and Adnexectomy: A Case Report and Literature Review","volume":"46","author":"Cokan","year":"2018","journal-title":"J. Int. Med. Res."},{"key":"ref_8","first-page":"e18588","article-title":"Computed Tomography and Magnetic Resonance Imaging Appearances of Abdomen and Pelvis Gossypibomas at the Varied Durations After Cesarean Section","volume":"13","author":"Bai","year":"2021","journal-title":"Cureus"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.jss.2006.08.001","article-title":"Retained Foreign Bodies after Surgery","volume":"138","author":"Lincourt","year":"2007","journal-title":"J. Surg. Res."},{"key":"ref_10","first-page":"1097","article-title":"Jejunocolonic fistula caused by a gauze compress","volume":"20","author":"Casal","year":"1961","journal-title":"Rev. Espanola Las Enfermedades Apar. Dig. Nutr."},{"key":"ref_11","first-page":"199","article-title":"Intestinal Obstruction Due to Retained, Eroding Surgical Sponge. Case Report","volume":"155","author":"Khwaja","year":"1989","journal-title":"Acta Chir. Scand."},{"key":"ref_12","first-page":"525","article-title":"An unclear abdominal tumor. A pseudocyst in the mid abdomen caused by a retained abdominal towel from a previous cesarean section","volume":"32","author":"Reinke","year":"1992","journal-title":"Radiologe"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"598","DOI":"10.3109\/00016349409006282","article-title":"Spontaneous Closure of Enterovaginal Fistula Caused by a Neglected Foreign Body","volume":"73","author":"Haddad","year":"1994","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s10350-004-6124-1","article-title":"Gossypiboma\u2014\u201ca Surgeon\u2019s Legacy\u201d: Report of a Case and Review of the Literature","volume":"45","author":"Rajagopal","year":"2002","journal-title":"Dis. Colon Rectum"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1097\/01.rlu.0000170227.56173.2f","article-title":"FDG PET CT Features of an Intraabdominal Gossypiboma","volume":"30","year":"2005","journal-title":"Clin. Nucl. Med."},{"key":"ref_16","first-page":"88","article-title":"An Unusual Abdominal Mass: Case Report","volume":"84","author":"Saidi","year":"2007","journal-title":"East Afr. Med. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1186\/1757-1626-1-220","article-title":"Gossypiboma: A Case Report","volume":"1","author":"Aminian","year":"2008","journal-title":"Cases J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1097\/OGX.0b013e318173538e","article-title":"Transmural Migration of Retained Surgical Sponges: A Systematic Review","volume":"63","author":"Zantvoord","year":"2008","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e72","DOI":"10.1259\/bjr\/32683906","article-title":"Spontaneous Transmural Migration of Retained Surgical Textile into Both Small and Large Bowel: A Rare Cause of Intestinal Obstruction","volume":"82","author":"Tandon","year":"2009","journal-title":"Br. J. Radiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1016\/j.forsciint.2010.01.013","article-title":"The Importance of Medico-Legal Evaluation in a Case with Intraabdominal Gossypiboma","volume":"198","author":"Dizdar","year":"2010","journal-title":"Forensic Sci. Int."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1007\/s00404-010-1412-6","article-title":"Textiloma, a Rare Pelvic Tumor","volume":"282","author":"Dash","year":"2010","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"221","DOI":"10.4103\/1319-3767.65195","article-title":"Intraluminal Migration of Surgical Sponge: Gossypiboma","volume":"16","author":"Patil","year":"2010","journal-title":"Saudi J. Gastroenterol. Off. J. Saudi Gastroenterol. Assoc."},{"key":"ref_23","first-page":"54","article-title":"Textiloma, Migration of Retained Long Gauze from Abdominal Cavity to Intestine","volume":"15","author":"Govarjin","year":"2010","journal-title":"J. Res. Med. Sci. Off. J. Isfahan Univ. Med. Sci."},{"key":"ref_24","first-page":"294","article-title":"Gossypiboma: A Rare Abdominal Lesion of Women after Cesarean Section, Usually Misdiagnosed as a Neoplasm","volume":"38","author":"Mavrigiannaki","year":"2011","journal-title":"Clin. Exp. Obstet. Gynecol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1159\/000338833","article-title":"Gossypiboma Mimicking Gastrointestinal Stromal Tumor Causing Intestinal Obstruction: A Case Report","volume":"6","author":"Kawamura","year":"2012","journal-title":"Case Rep. Gastroenterol."},{"key":"ref_26","first-page":"263841","article-title":"Beyond a Gossypiboma","volume":"2012","author":"Quraishi","year":"2012","journal-title":"Case Rep. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"bcr2013010059","DOI":"10.1136\/bcr-2013-010059","article-title":"Beware of Gossypibomas","volume":"2013","author":"Karasaki","year":"2013","journal-title":"BMJ Case Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"rjt032","DOI":"10.1093\/jscr\/rjt032","article-title":"Intraluminal Migration of Retained Surgical Sponge as a Cause of Intestinal Obstruction","volume":"2013","author":"Rafie","year":"2013","journal-title":"J. Surg. Case Rep."},{"key":"ref_29","first-page":"578027","article-title":"Conservative Treatment of a Gossypiboma Causing Uterine Wound Dehiscence","volume":"2013","author":"Usta","year":"2013","journal-title":"Case Rep. Obstet. Gynecol."},{"key":"ref_30","first-page":"83","article-title":"An intravesical foreign body by migration of remnant gauze into the bladder: A case report","volume":"60","author":"Kashima","year":"2014","journal-title":"Hinyokika Kiyo"},{"key":"ref_31","first-page":"65","article-title":"Gossypiboma Diagnosed Fifteen Years after a Cesarean Section: A Case Report","volume":"2014","author":"Rehman","year":"2014","journal-title":"Qatar Med. J."},{"key":"ref_32","first-page":"713428","article-title":"Gossypiboma Posing as a Diagnostic Dilemma: A Case Report and Review of the Literature","volume":"2014","author":"Srivastava","year":"2014","journal-title":"Case Rep. Surg."},{"key":"ref_33","first-page":"539","article-title":"Small Bowel Obstruction and Enterocolic Fistula from a Gossypiboma after Caesarean Section","volume":"63","author":"Faghani","year":"2014","journal-title":"West Indian Med. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"236","DOI":"10.12965\/jer.150227","article-title":"Inflammatory Gossypiboma in Young Female Athlete","volume":"11","author":"Lee","year":"2015","journal-title":"J. Exerc. Rehabil."},{"key":"ref_35","first-page":"QD01","article-title":"Gossypiboma Mimicking as Dermoid Cyst of Ovary: A Case Report","volume":"9","author":"Rafat","year":"2015","journal-title":"J. Clin. Diagn. Res. JCDR"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.ijscr.2015.12.032","article-title":"Gossypiboma Revisited: A Never Ending Issue","volume":"19","author":"Rabie","year":"2015","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_37","first-page":"3258782","article-title":"Intestinal Obstruction and Ileocolic Fistula Due to Intraluminal Migration of a Gossypiboma","volume":"2016","author":"Margonis","year":"2016","journal-title":"Case Rep. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.ijscr.2016.10.026","article-title":"Surgical Sponge Forgotten for Nine Years in the Abdomen: A Case Report","volume":"28","author":"Susmallian","year":"2016","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.eucr.2016.11.022","article-title":"Urinary Retention as the Only Symptom of Retained Surgical Sponge (Gossypiboma), 29 Years After Cesarean Procedure","volume":"11","author":"Konstantinidis","year":"2017","journal-title":"Urol. Case Rep."},{"key":"ref_40","first-page":"77","article-title":"Intraabdominal Gossypiboma: Report of Two Cases","volume":"34","author":"Oran","year":"2018","journal-title":"Turk. J. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1056\/NEJMicm1708836","article-title":"Two Pelvic Masses","volume":"378","author":"Kondo","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_42","first-page":"123","article-title":"Intraabdominal Gossypibomas with Variable CT Appearance: A Case Report","volume":"69","author":"Fatima","year":"2019","journal-title":"JPMA J. Pak. Med. Assoc."},{"key":"ref_43","first-page":"338","article-title":"Gossypiboma in Abdomen: Retained Surgical Gauze after a Cesarean Section","volume":"40","author":"Bilali","year":"2019","journal-title":"Il Giornale Di Chirurgia\u2014J. Ital. Surg. Assoc."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"335","DOI":"10.11604\/pamj.2020.36.335.25464","article-title":"Gossypiboma: The Failure of a Successful Intervention","volume":"36","author":"Mejri","year":"2020","journal-title":"Pan Afr. Med. J."},{"key":"ref_45","first-page":"147","article-title":"Gossypiboma: A Case Series and Literature Review","volume":"30","author":"Alemu","year":"2020","journal-title":"Ethiop. J. Health Sci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.ijscr.2020.04.058","article-title":"Oh, My Gauze !!!- A Rare Case Report of Laparoscopic Removal of an Incidentally Discovered Gossypiboma during Laparoscopic Cholecystectomy","volume":"72","author":"Sankpal","year":"2020","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.ijscr.2020.01.018","article-title":"Retained Intra-Abdominal Surgical Sponge Causing Ileocolic Fistula Diagnosed by Colonoscopy","volume":"67","author":"Omar","year":"2020","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_48","first-page":"e10930","article-title":"Intra-Abdominal Gossypiboma: A Rare Cause of Palpable Abdominal Mass with a Review of Literature","volume":"12","author":"Hakami","year":"2020","journal-title":"Cureus"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1080\/01443615.2020.1828317","article-title":"Hysteroscopic Removal of a Gauze Inadvertently Retained in Uterus for Two Years Following Caesarean Section","volume":"41","author":"Amodeo","year":"2021","journal-title":"J. Obstet. Gynaecol. J. Inst. Obstet. Gynaecol."},{"key":"ref_50","first-page":"e17846","article-title":"Gossypiboma Complicating as Colouterine Fistula in a Young Woman Post-Cesarean Section","volume":"13","author":"Jha","year":"2021","journal-title":"Cureus"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"105521","DOI":"10.1016\/j.ijscr.2021.01.015","article-title":"Gossypiboma-an Unusual Cause of Surgical Abdomen and Surgeon\u2019s Nightmare: A Rare Case Report","volume":"80","year":"2021","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"107439","DOI":"10.1016\/j.ijscr.2022.107439","article-title":"Mesenteric Textiloma Early Discovery in a 31-Year-Old Female: A Case Report","volume":"97","author":"Munihire","year":"2022","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_53","first-page":"373","article-title":"A Case Report of Abdominal Sponge in Ileum in a Patient with Intestinal Obstruction","volume":"71","author":"Ammar","year":"2021","journal-title":"JPMA J. Pak. Med. Assoc."},{"key":"ref_54","first-page":"e21375","article-title":"Laparoscopic Removal of Retained Surgical Sponge After Caesarean Section: A Case Report","volume":"14","author":"Khanduri","year":"2022","journal-title":"Cureus"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1080\/01443615.2020.1755835","article-title":"Foreign Body under the Skin after Caesarean Section: Case Report","volume":"41","author":"Elci","year":"2021","journal-title":"J. Obstet. Gynaecol. J. Inst. Obstet. Gynaecol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"139","DOI":"10.6118\/jmm.22022","article-title":"A Case Report of Neglected Gossypiboma Causing Abdominal Pain for 20 Years Post-Cesarean Section","volume":"28","author":"Min","year":"2022","journal-title":"J. Menopausal Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/16\/5353\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:35:58Z","timestamp":1760128558000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/16\/5353"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,17]]},"references-count":56,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["jcm12165353"],"URL":"https:\/\/doi.org\/10.3390\/jcm12165353","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,17]]}}}