Emergency Presentation of Abdominal Pain with Unusual Etiology

  • Abdul Naeem
  • Maria Aziz
  • Alia Mir
  • Hamid Sial
  • Muhammad Mudassir Shafiq
  • Iram Arshad
Keywords: Gossybioma, Abdominal pain, Laparotomy.


Abdominal pain has vast differentials and routine etiologies are diagnosed easily. Difficulty arises with uncommon presentation. This is a case of 28 years old lady presenting to emergency department of Holy Family Hospital, Rawalpindi with worsening abdominal pain, vomiting and loose stools over 2 weeks. Routine examination and workup did not help to find any cause. Ultrasound abdomen suspected matted gut loops with enlarged lymph nodes. CECT abdomen confirmed a non-differentiating tissue collection in right iliac fossa. Later diagnosis of complicated gossybioma (retained gauze surrounded by fibrotic tissue with entero-enteric fistula and fecolith in appendix) was confirmed by laparoscopy that was surgically removed. Conclusion: Gossybioma is infrequent but avoidable complication that needs to be considered by surgeon meticulously especially by swab counting, avoiding staff change over during procedure and consideration in follow up visit.


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How to Cite
Naeem A, Aziz M, Mir A, Sial H, Shafiq M, Arshad I. Emergency Presentation of Abdominal Pain with Unusual Etiology. JRMC [Internet]. 30Jun.2022 [cited 24Sep.2022];26(2):333-6. Available from: http://www.journalrmc.com/index.php/JRMC/article/view/1832
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