An unusual cause of chronic diarrhea

Excerpt

Gossypiboma or textiloma is a mass formed around a cotton matrix left within the body. They are usually seen following abdominal surgery with varying intervals to presentation and diagnosis. The clinical manifestations are protean, and they may present as pseudotumor, septic collection, or fistulization with or without transmigration and perforation. Presentation with diarrhea is rare. This colonoscopic image (Fig. 1a) is from a 36-year-old mother symptomatic with painful non-bloody chronic diarrhea of 8 months following lower segment Cesarean section. The gossypiboma was firmly adherent to the wall of the sigmoid, associated with pus discharge into the lumen, and the remaining colon was normal. Contrast-enhanced computed tomography of the abdomen (Fig. 1b) reveals a well-defined low-density heterogeneous mass with an external high-density contrast-enhancing wall and an internal spongiform pattern containing multiple small air bubbles [1]. The treatment is surgical removal, although endoscopic retrieval of the gauze has also been reported [2].

…