PDF(Pubmed)
Abstract：
BACKGROUND: Gossypiboma, a retained surgical sponge with a foreign body reaction, is an unusual but serious complication seen in open abdominal surgeries. It is exceptionally rare following head and neck surgeries. Here, we present a case of Gossypiboma of the upper airway following tracheostomy.
METHODS: A 32-year-old male presented with stridor and difficulty breathing one-month post-tracheostomy after a severe head injury following a road traffic accident. A neck radiograph was unremarkable, and a computed tomography (CT) scan of the neck showed a well-defined homogenous curvilinear membrane extending from the hypopharynx to the upper trachea. Bronchoscopic evaluation of the larynx and upper trachea revealed a retained surgical sponge, which was retrieved. The patient\'s breathing improved drastically post intervention.
CONCLUSIONS: Gossypiboma may go undetected in radiographs and may also present atypically as a homogenous membrane on a CT scan of the neck. Though rare, retained surgical items can have profound medicolegal and professional consequences on physicians. Hence, a strong clinical suspicion and vigilance for gossypiboma is necessary for patients presenting with respiratory distress post-tracheostomy.
METHODS: A 32-year-old male presented with stridor and difficulty breathing one-month post-tracheostomy after a severe head injury following a road traffic accident. A neck radiograph was unremarkable, and a computed tomography (CT) scan of the neck showed a well-defined homogenous curvilinear membrane extending from the hypopharynx to the upper trachea. Bronchoscopic evaluation of the larynx and upper trachea revealed a retained surgical sponge, which was retrieved. The patient\'s breathing improved drastically post intervention.
CONCLUSIONS: Gossypiboma may go undetected in radiographs and may also present atypically as a homogenous membrane on a CT scan of the neck. Though rare, retained surgical items can have profound medicolegal and professional consequences on physicians. Hence, a strong clinical suspicion and vigilance for gossypiboma is necessary for patients presenting with respiratory distress post-tracheostomy.
摘要：
背景：棉瘤，保留有异物反应的手术海绵，是开腹手术中一种不寻常但严重的并发症。头颈部手术后非常罕见。这里,我们介绍了一例气管造口术后上呼吸道的Gossyboma。
方法：一名32岁男性在道路交通事故后严重头部受伤，气管造口术后一个月出现喘鸣和呼吸困难。颈部X光片并不明显，颈部的计算机断层扫描（CT）扫描显示，从下咽延伸到上气管的轮廓清晰的均匀曲线膜。喉和上气管的支气管镜评估显示保留的手术海绵，已被检索。患者的呼吸在干预后得到了显著改善。
结论：棉瘤在X线片上可能未被发现，在颈部CT扫描上也可能表现为异型同质膜。虽然罕见，保留的手术物品会对医生产生深远的法医学和专业后果。因此，对于气管造口术后出现呼吸窘迫的患者，有必要强烈的临床怀疑和警惕gossyboma。
方法：一名32岁男性在道路交通事故后严重头部受伤，气管造口术后一个月出现喘鸣和呼吸困难。颈部X光片并不明显，颈部的计算机断层扫描（CT）扫描显示，从下咽延伸到上气管的轮廓清晰的均匀曲线膜。喉和上气管的支气管镜评估显示保留的手术海绵，已被检索。患者的呼吸在干预后得到了显著改善。
结论：棉瘤在X线片上可能未被发现，在颈部CT扫描上也可能表现为异型同质膜。虽然罕见，保留的手术物品会对医生产生深远的法医学和专业后果。因此，对于气管造口术后出现呼吸窘迫的患者，有必要强烈的临床怀疑和警惕gossyboma。
