Gossypiboma with bleeding from fistula to the colon observed by colonoscopy.
A gossypiboma is a mass of cotton sponge left in the body postoperatively. Here, we report a case of gossypiboma with bleeding through a fistula to the colon, which became clinically evident 24 years after gynecological surgery, and resembled a bleeding diverticulum at colonoscopy. A 67-year-old woman presented with anemia and hematochezia. She had undergone a hysterectomy for myoma uteri 24 years earlier. Colonoscopy showed a deep depressed lesion mimicking a diverticulum with bleeding in the transverse colon. A contrast-enhanced computed tomography was interpreted as revealing a 6-cm thick-walled tumor, containing an air bubble, and a fistula between the mass and the transverse colon. The patient underwent laparotomy, with the preoperative expectation that the mass was a penetrating submucosal tumor. Pathological findings revealed denatured cotton tissues surrounded by reactive tissues to the foreign body. Despite its rarity, gossypiboma should be considered in patients with an intra-abdominal mass who have a history of laparotomy. Gossypiboma can cause fistula to the colon and bleeding. Imaging studies and the clinical course may mimic a malignant tumor.
Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan. nn13543@kchnet.or.jp.
Naoyuki
N
Nishimura
Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan.
Motowo
M
Mizuno
Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan.
Yuichi
Y
Shimodate
Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan.
Akira
A
Doi
Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan.
Hirokazu
H
Mouri
Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan.
Kazuhiro
K
Matsueda
Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan.
Hiroshi
H
Yamamoto
D000368:Aged; D003106:Colon; D003108:Colonic Diseases / Q000209:etiology*; D003110:Colonic Neoplasms / Q000175:diagnosis; D003113:Colonoscopy; D032561:Cotton Fiber; D003937:Diagnosis, Differential; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000175:diagnosis*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D007412:Intestinal Fistula / Q000209:etiology*; D014057:Tomography, X-Ray Computed
Bleeding; Colonoscopy; Fistula; Gossypiboma