Complete transmural migration of a retained surgical sponge: an atypical case in image mimicking intussusception

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Abstract

Rationale:

Intraluminal migration of a retained surgical sponge causing intestinal obstruction and fistula is extremely rare occurrence.

Patient concerns:

A case of a 35-year-old male, who complaining a diffuse abdominal pain beginning three days earlier. He also complained of occasional vomiting, nonspecific abdominal pain, and an unintentional 15 kg weight loss during the past 2 years. However, there were no clear findings in previous laboratory work. He had received an open appendectomy approximately 4 years earlier.

Diagnoses:

Retained surgical sponge.

Interventions:

A contrast-enhanced CT of the abdomen showed a clear invagination of the small intestine. However, intraoperatively, we could not find an intestinal segment with intussusception. After the adhesive intestine was detached, a jejunal−ileal cross-linked fistula was found. More surprisingly, a retained surgical sponge was found inside the ileal fistula when the cross-linked fistula was detached.

Outcomes:

The patient was discharged 7 days after surgery.

Lessons:

This is the first report showing an atypical image of a complete transmural migration of a retained surgical sponge mimicking intussusception.

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