Pararenal gossypiboma presenting as a renal complicated cyst: A case report

Authors

  • Chatchawet Lewroatsap Division of Urology, Department of surgery, Faculty of Medicine, Thammasat University, Bangkok, Thailand

Keywords:

Pararenal gossypiboma, renal complicated cyst

Abstract

Objective: To report the guideline for diagnosis, problem, obstruction, care and prevention of gossypiboma in patients.
Material and methods: The 58 years-old-male patient is found large complex renal cyst in the right kidney accidentally from the physical examination without abnormal condition. The result of computed tomography found the large cystic mass with internal hyperdensity area at upper pole of right kidney which is complex cyst that categorized in Bosniack category III with 50% of chance for cystic renal cell carcinoma (cystic RCC). Then the patient decided to be operated the transabdominal right radical nephrectomy and found that there was severe perinephric adhesion with large cystic tumor next to the upper pole of right kidney that contained the thick capsule. Once opened the specimen, found that it was surgical gauze merge with purulent fluid corresponding to the history that he had been operated to take the renal stone away 15 years ago.
Results: The patient was pararenal gossypiboma that represented by renal complicated cyst that has no report in the literature reviews. The most of them reported on pararenal or intrarenal solid tumor (pseudotumor). After treatment, the patient had no complication and discharged within 1 week.
Conclusion: Gossypiboma in patient is not commonly found but result of severe complication. The patient with kidney operation history, if renal complex cyst or pseudotumor found, it should realize gossypiboma as differential diagnosis even there is no abnormalcondition. The key preventions include risk awareness, surgical gauze count that should be contend carefully along with the record and communication within the team and also using of gauze with radiopaque marker.

References

1. Sakorafas GH, Sampanis D, Lappas C, et al. Retained surgical sponges: what the practicing clinician should know. Langenbecks Arch Surg 2010;395:1001-1007.
2. Gawande AA, Studdert DM, Orav EJ, et al. Risk factors for retained instruments and sponges after surgery. N Engl J Med 2003;348:229-235.
3. Wang CF, Cipolla J, Seamon MJ, et al. Gastrointestinal complications related to retained surgical foreign bodies (RSFB): A concise review. OPUS 12 Scientist 2009;3:11-18.
4. Agras K, Serefoglu EC, Duran E, et al. Retroperitoneal textiloma mimicking a renal tumor: Case report. Int Urol Nephrol 2007;39: 401-403
5. Bellin MF, Hornoy B, Richard F, et al. Perirenal textiloma: MR and serial CT appearance. Eur Radiol 1998;8:57-59.
6. Manzella A, Filho PB, Albuquerque E, et al. Imaging of gossypibomas: Pictorial review. AJR 2009;193:94-101.
7. Meir BD, Lask D, Koren R, et al. Intrarenal foreign body presenting as a solid tumor. Urology 2003;61:1035xii-xiii.
8. Farina LA, Villavicencio H, Chechile G. Preoperatively recognized chronically retained pararenal gauzoma. Int Urol Nephrol 1995;27: 33-35.
9. Coelho RF, Mitre AI, Srougi M. Intrarenal foreign body presenting as a renal calculus. CLINICS 2007;62:527-528.
10. Campbell SC, Lane BR. Malignant renal tumors. In Alan J. Wein. Campbell-Walsh Urology 10th ed. Philadelphia: W.B. Saunder company, 2012: 1413-1474.
11. Nassir A, Jollimore J, Gupta R, et al. Multilocular cystic renal cell carcinoma: A series of 12 cases and review of the literature. UROLOGY
2002;60:421-427.
12. Macario A, Morris D, Morris S. Initial clinical evaluation of a handheld device for detecting retained surgical gauze sponges using radiofrequency identification technology. Arch Surg 2006;141:659-662.

Downloads

Published

2017-12-26

How to Cite

Lewroatsap, C. (2017). Pararenal gossypiboma presenting as a renal complicated cyst: A case report. Insight Urology, 38(2), 28–35. Retrieved from https://he02.tci-thaijo.org/index.php/TJU/article/view/106401

Issue

Section

Case Report