Post Caesarean Transmural Migration of Gauze Expelled Rectally Without Any Complication: A Favorable Outcome

Abstract

Gossypiboma (GP) is a feared complication for all surgeons. Transmural migration of gauze presents with gastrointestinal symptoms, rarely does it remain asymptomatic. It may require surgical intervention or rarely gauze is expelled per rectally. We would like to report a case of 30 year Primigravida patient that underwent an elective caesarean section, remained asymptomatic post operatively. During her first week of follow up abdomen was soft, wound healthy and no relevant signs or symptoms. After 4th week of surgery she developed colicky abdominal pain, nausea and vomiting for which she visited a doctor, no significant clinical signs or symptoms could be appreciated. Ultrasound was suggestive of gallstones for which she was prepared for laparoscopic cholecystectomy. On the pre-operative day for bowel preparation laxatives and enema was given after which she defecated the gauze piece. Computed tomographic scan with double contrast was done which reported bowel loop dilation and thickening with no signs of perforation. Patient remained asymptomatic after follow up.