A CASE OF FOREIGN BODY GRANULOMA (GAUZE) SUSPECTED BY DIAGNOSTIC IMAGINGS

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 62; no. 5; pp. 1321 - 1324
• Main Authors: SEKIGUCHI, Katsuya, KAI, Toshihiro, YAMAMOTO, Hiroshi, TAKEMOTO, Nobuyuki, KONISHI, Fumio, OKADA, Shinichiro
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 2001
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.62.1321

A 62-year-old woman was seen at the hospital, because of epigastric pain in May 1997. These were previous histories of undergoing a distal gastrectomy for peptic ulcer at the age of 19 and caesarian section at the age of 36. A round-shaped mass, 5cm in size, was palpated in the left lower abdomen on a physical examination. She was admitted for further evaluation of the lesion. Abdominal ultrasonography (US) showed linear high-echoes in a low-echoic mass, whose border was clear. CT scan revealed a well-encapsulated low density mass. Upon laparotomy, the lesion was located in the mesentery of the small bowel and firmly adhered to it. A partial resection of the small bowel including the tumor was performed. Pathological examination finally demonstrated a granulomatous mass with chronically inflammatory changes caused by a retained surgical gauze. The accurate pre-operative diagnosis is considered to be difficult in such cases even by making the most use of imagings. However, both unusual US and/or CT findings of the lesion wlth previous surgical history help us to suspect the diagnosis of retained surgical materials.