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Gossypiboma mimicking gastrointestinal stromal tumor causing intestinal obstruction: a case report.

Kawamura Y, Ogasawara N, Yamamoto S, Sasaki M, Kawamura N, Izawa S, Kobayashi Y, Kamei S, Miyachi M, Kasugai K - Case Rep Gastroenterol (2012)

Bottom Line: The CT and MRI findings were consistent with those of a gastrointestinal stromal tumor (GIST) causing ileus of the small intestine.The operative findings revealed a hard, solid tumor adhering to the surrounding small intestine.If a patient has a history of surgery, the possibility of gossypiboma should be considered when CT or MRI findings indicate features of GIST.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.

ABSTRACT
A 41-year-old woman was admitted to our hospital with abdominal pain that developed about 1 year after a Cesarean section. Pelvic computed tomography (CT) revealed diffuse dilation of the small intestine with fluid shadows and a pelvic tumor 55 mm in diameter. The density of the tumor, which was not enhanced by intravenous contrast medium, was diffuse and similar to that of muscular tissue, whereas the density of a capsule surrounding the mass was relatively high. T1- and T2-weighted pelvic magnetic resonance imaging (MRI) of the tumor revealed the same diffuse low-intensity signals as muscular tissue, and diffuse high-intensity signals, respectively. The CT and MRI findings were consistent with those of a gastrointestinal stromal tumor (GIST) causing ileus of the small intestine. As inserting an ileus tube did not improve her symptoms, the patient was scheduled for tumor resection. The operative findings revealed a hard, solid tumor adhering to the surrounding small intestine. The macroscopic findings revealed that the tumor consisted of layers of stratified gauze surrounded by a thick granulomatous wall. The gossypiboma was considered to have originated from gauze that had been left behind after the Cesarean section. If a patient has a history of surgery, the possibility of gossypiboma should be considered when CT or MRI findings indicate features of GIST.

No MeSH data available.


Related in: MedlinePlus

Pelvic CT findings. a The pelvic tumor 55 mm in diameter with surrounding capsule has diffuse low density similar to that of muscular tissue, and the surrounding capsule has relatively high density (arrowheads). Diffuse dilation of the small intestine and fluid shadows are also evident (arrows). b The surrounding capsule is slightly enhanced by intravenous contrast medium, whereas main contents are not.
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Figure 1: Pelvic CT findings. a The pelvic tumor 55 mm in diameter with surrounding capsule has diffuse low density similar to that of muscular tissue, and the surrounding capsule has relatively high density (arrowheads). Diffuse dilation of the small intestine and fluid shadows are also evident (arrows). b The surrounding capsule is slightly enhanced by intravenous contrast medium, whereas main contents are not.

Mentions: Physical examination revealed a tender lower abdomen and hyperactive bowel sounds. Rectal findings were normal. Laboratory investigations revealed white blood cells 7,400/mm3, C-reactive protein 0.61 mg/dl, hemoglobin 11.4 g/dl, total protein 6.0 g/dl and no abnormalities in liver and renal function tests. Abdominal and pelvic CT (fig. 1) revealed diffuse dilation of the small intestine with fluid shadows and a pelvic tumor 55 mm in diameter, but no thickening of the small intestinal wall, dilation of the large intestine or ascites. The density of the main tumor content was diffuse and low and similar to that of muscular tissue (fig. 1a), whereas that of a surrounding capsule was relatively high. Intravenous contrast medium did not enhance the main content of the mass, but slightly enhanced the surrounding capsule (fig. 1b).


Gossypiboma mimicking gastrointestinal stromal tumor causing intestinal obstruction: a case report.

Kawamura Y, Ogasawara N, Yamamoto S, Sasaki M, Kawamura N, Izawa S, Kobayashi Y, Kamei S, Miyachi M, Kasugai K - Case Rep Gastroenterol (2012)

Pelvic CT findings. a The pelvic tumor 55 mm in diameter with surrounding capsule has diffuse low density similar to that of muscular tissue, and the surrounding capsule has relatively high density (arrowheads). Diffuse dilation of the small intestine and fluid shadows are also evident (arrows). b The surrounding capsule is slightly enhanced by intravenous contrast medium, whereas main contents are not.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3369411&req=5

Figure 1: Pelvic CT findings. a The pelvic tumor 55 mm in diameter with surrounding capsule has diffuse low density similar to that of muscular tissue, and the surrounding capsule has relatively high density (arrowheads). Diffuse dilation of the small intestine and fluid shadows are also evident (arrows). b The surrounding capsule is slightly enhanced by intravenous contrast medium, whereas main contents are not.
Mentions: Physical examination revealed a tender lower abdomen and hyperactive bowel sounds. Rectal findings were normal. Laboratory investigations revealed white blood cells 7,400/mm3, C-reactive protein 0.61 mg/dl, hemoglobin 11.4 g/dl, total protein 6.0 g/dl and no abnormalities in liver and renal function tests. Abdominal and pelvic CT (fig. 1) revealed diffuse dilation of the small intestine with fluid shadows and a pelvic tumor 55 mm in diameter, but no thickening of the small intestinal wall, dilation of the large intestine or ascites. The density of the main tumor content was diffuse and low and similar to that of muscular tissue (fig. 1a), whereas that of a surrounding capsule was relatively high. Intravenous contrast medium did not enhance the main content of the mass, but slightly enhanced the surrounding capsule (fig. 1b).

Bottom Line: The CT and MRI findings were consistent with those of a gastrointestinal stromal tumor (GIST) causing ileus of the small intestine.The operative findings revealed a hard, solid tumor adhering to the surrounding small intestine.If a patient has a history of surgery, the possibility of gossypiboma should be considered when CT or MRI findings indicate features of GIST.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.

ABSTRACT
A 41-year-old woman was admitted to our hospital with abdominal pain that developed about 1 year after a Cesarean section. Pelvic computed tomography (CT) revealed diffuse dilation of the small intestine with fluid shadows and a pelvic tumor 55 mm in diameter. The density of the tumor, which was not enhanced by intravenous contrast medium, was diffuse and similar to that of muscular tissue, whereas the density of a capsule surrounding the mass was relatively high. T1- and T2-weighted pelvic magnetic resonance imaging (MRI) of the tumor revealed the same diffuse low-intensity signals as muscular tissue, and diffuse high-intensity signals, respectively. The CT and MRI findings were consistent with those of a gastrointestinal stromal tumor (GIST) causing ileus of the small intestine. As inserting an ileus tube did not improve her symptoms, the patient was scheduled for tumor resection. The operative findings revealed a hard, solid tumor adhering to the surrounding small intestine. The macroscopic findings revealed that the tumor consisted of layers of stratified gauze surrounded by a thick granulomatous wall. The gossypiboma was considered to have originated from gauze that had been left behind after the Cesarean section. If a patient has a history of surgery, the possibility of gossypiboma should be considered when CT or MRI findings indicate features of GIST.

No MeSH data available.


Related in: MedlinePlus