One doctor lost a towel during surgery. Another found it in his patient’s abdomen. Quite a case of ‘Lost and Found’.
A woman, aged 74, made her way to the emergency unit following a complaint of colicky pain, nausea and post-prandial vomiting. Upon inspection, the doctors did not notice any abdominal distention. However, the woman’s history disclosed some interesting findings.
A Remarkable History
3 years ago, the woman had herself opened up for cholecystectomy and hernia repair at an institution. Just one year into it and she underwent a second repair for her hernia, via a non-absorbable mesh, at the same place. The initial repair clocked in a short period of febrility. However, she did not experience any fever after that for the last two years.
Radiographs Indicate a Foreign Body; Surgery Confirms a Towel
As a kick-off, the patient underwent a whole blood count which showed markedly raised WBCs. Next, the doctors conducted some radiographic assays on the account of her abdominal pain.
Plain radiography did not reveal any abnormality. But a contrast enhanced abdominal CT scan clearly showed the presence of a well-defined round mass with air-bubbles in the center, resting in the woman’s abdomen. It showed a fistula between the cavity subsuming the mass and the GI tract at the level of proximal jejunum.
On confirmation of a foreign body in the patient’s abdomen, doctors decided for a laparotomy. To their awe, it turned out to be full- fledged towel. What are the odds?
Towel in the Bowel!
The towel was completely covered in small bowel’s mesentery and it showed adhesions to both the non-absorbable mesh and the woman’s gut. Anyhow, doctors retrieved it completely including the part forming a fistula with proximal jejunum. They then restored the continuity of the small bowel. Good thing, the patient is asymptomatic now.
