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Gossypiboma with bleeding from fistula to the colon observed by colonoscopy

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Abstract

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.

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Acknowledgements

The authors thank to Dr. William R. Brown (Denver, Colorado) for assistance in preparation of the manuscript.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan

    Naoyuki Nishimura, Motowo Mizuno, Yuichi Shimodate, Akira Doi, Hirokazu Mouri, Kazuhiro Matsueda & Hiroshi Yamamoto

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  1. Naoyuki Nishimura
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  2. Motowo Mizuno
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  3. Yuichi Shimodate
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  4. Akira Doi
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  5. Hirokazu Mouri
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  6. Kazuhiro Matsueda
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  7. Hiroshi Yamamoto
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Corresponding author

Correspondence to Naoyuki Nishimura.

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Conflict of Interest

Naoyuki Nishimura, Motowo Mizuno, Yuichi Shimodate, Akira Doi, Hirokazu Mouri, Kazuhiro Matsueda, and Hiroshi Yamamoto declare that they have no conflict of interest.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all patients for inclusion in the study.

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Nishimura, N., Mizuno, M., Shimodate, Y. et al. Gossypiboma with bleeding from fistula to the colon observed by colonoscopy. Clin J Gastroenterol 10, 37–40 (2017). https://doi.org/10.1007/s12328-016-0699-7

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  • DOI: https://doi.org/10.1007/s12328-016-0699-7

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