Misdiagnosis of gossypiboma as hydatid cyst

Indian Journal of Gastroenterology, Dec 2011

Ali Erkan Duman, Osman Ersoy, Osman Abbasoglu, Ozgur Harmanci, Musa Aydinli, Yusuf Bayraktar, Ferhun Balkanci

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Misdiagnosis of gossypiboma as hydatid cyst

Ali Erkan Duman 0 1 3 Osman Ersoy 0 1 3 Osman Abbasoglu 0 1 3 Ozgur Harmanci 0 1 3 Musa Aydinli 0 1 3 Yusuf Bayraktar 0 1 3 Ferhun Balkanci 0 1 3 0 O. Abbasoglu Faculty of Medicine, Department of General Surgery, Hacettepe University , Ankara, Turkey 1 A. E. Duman Faculty of Medicine, Department of Internal Medicine, Hacettepe University , Ankara, Turkey 2 ) Department of Gastroenterology, Kocaeli University Medical Faculty Hospital , Eski Istanbul yolu 10. Km, 41000 Kocaeli, Turkey 3 F. Balkanci Faculty of Medicine, Department of Radiology, Hacettepe University , Ankara, Turkey - A 51-year-old woman was admitted for diabetes control. She was found to have a firm, mobile, large epigastric mass during physical examination. Laboratory findings were within normal range. She had undergone cholecystectomy at another hospital 8 years ago. On computerized tomography (CT) of abdomen showed a large intra-abdominal cystic mass measuring 102 cm 106 cm 181 cm, originating from duodenopyloric junction, which compressed duodenum and pylorus. The appearance of the mass was consistent with type II hydatid cyst (Fig. 1). The patient was advised albendazole therapy; 2 months later, the cyst was treated by puncture, aspiration, injection of a helminthicide, and reaspiration (PAIR) technique. Analysis of cystic fluid was not consistent with hydatid cyst. A post-treatment CT scan showed a reduced size of the cyst; however it returned to its original size within 3 months after treatment. The patient underwent a diagnostic laparotomy which detected four sponges within the cyst (Fig. 2). Fig. 1 Computerized tomography of abdomen showing a large intraabdominal cystic mass Fig. 2 Appearance of sponges during laparotomy Sponges used during surgical operations are occasionally left in abdominal cavity accidentally. The amount of actual occurrences is possibly more than what are reported [1]. Retained intra-abdominal sponges have been misdiagnosed preoperatively as lymphosarcoma, bowel tumor, tuberculosis, and ovarian tumor [2]. There has not been a misdiagnosis of a gossypiboma as hydatid cyst earlier. (...truncated)


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Ali Erkan Duman, Osman Ersoy, Osman Abbasoglu, Ozgur Harmanci, Musa Aydinli, Yusuf Bayraktar, Ferhun Balkanci. Misdiagnosis of gossypiboma as hydatid cyst, Indian Journal of Gastroenterology, 2011, pp. 285-285, Volume 30, Issue 6, DOI: 10.1007/s12664-011-0116-6