Intracranial Textiloma: Imaging Features and Literature Review

Background and Importance Intracranial textilomas are retained surgical sponges presenting as pseudomass lesions in postoperative patients usually with surrounding inflammatory reaction. Though rare, these are commonly misdiagnosed as postoperative hemorrhagic collections, abscesses, radionecrosis, or residual/recurrent mass lesions. We describe the imaging findings of intracranial textilomas diagnosed in four patients on follow-up postoperative imaging along with their characteristic imaging findings to help radiologists/neurosurgeons make accurate diagnosis. Clinical Presentation One patient had chronic headache without any focal neurological deficits. Rest of the patients were asymptomatic at the time of presentation Conclusion In postoperative scans, possibility of textilomas should be considered apart from residual/recurrent lesions, postoperative abscesses, or radionecrosis. Correct and timely diagnosis is important for further treatment planning and patient care.

Surgical and computed tomographic findings of retained surgical sponges in two dogs following abdominal surgery

Two dogs presented with chronic vomiting and an abdominal mass, respectively, for further investigation and treatment. Abdominal ultrasound revealed an intramural intestinal mass with a core of strongly echogenic interfaces surrounded by a rim of soft tissue echogenicity in one of the dogs and a well-demarcated soft tissue echogenicity mass in the other dog. Abdominal CT revealed an intramural intestinal mass with air attenuating centre surrounded by a soft tissue-attenuating rim in one of the dogs and a well-demarcated soft tissue-attenuating mass in the other dog. Abdominal exploration revealed a retained sponge within the intestine of one of the dogs and a sponge that adhered to the jejunum in the other dog. One of the dogs underwent intestinal resection and the other had a mass resection. One of the dogs was euthanatised due to an anastomotic leak and secondary peritonitis, and the other was free of clinical signs of abdominal disease 1 year after surgery.

Retained surgical sponges

National guidance is in place to minimise the number of cases of surgical instruments and sponges retained in a patient post-surgery. But is the existing strategy for prevention sufficient? Is this supposed 'never event' always avoidable? George Winter investigates.

Gossypiboma (retained surgical sponge) induces septic shock after previous breast surgery: A case report

Foreign body granuloma caused by retained surgical sponge is also called gossypiboma or textiloma, is mostly described in the abdominal cavity, with only a very few cases of retained surgical sponges located in breasts. A 48-year-old female came to our emergency department due to shortness of breath with consciousness disturbance. Sixteen years previously, she had gone through modified radical mastectomy. Eight years later, she received breast reconstruction. At emergency department, her hemodynamic status was unstable. Besides, there was one mass lesion with abscess in the right axillary region, and percutaneous abscess drainage was performed. She was sent to the medical intensive care unit for further care of septic shock. Because her symptoms and signs did not improve, we decided to perform fasciectomy and surprisingly found one retained surgical sponge in her breast. After the operation, she recovered well and the wound was stable. Due to limited literature available, we present a case of gossypiboma in the breast with a clinical manifestation of septic shock.