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Misdiagnosis of gossypiboma as hydatid cyst
Ali Erkan Duman
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Osman Ersoy
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Osman Abbasoglu
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Ozgur Harmanci
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Musa Aydinli
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Yusuf Bayraktar
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Ferhun Balkanci
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O. Abbasoglu Faculty of Medicine, Department of General Surgery, Hacettepe University
, Ankara,
Turkey
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A. E. Duman Faculty of Medicine, Department of Internal Medicine, Hacettepe University
, Ankara,
Turkey
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) Department of Gastroenterology, Kocaeli University Medical Faculty Hospital
, Eski Istanbul yolu 10. Km, 41000 Kocaeli,
Turkey
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F. Balkanci Faculty of Medicine, Department of Radiology, Hacettepe University
, Ankara,
Turkey
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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)