The importance of US and CT in the detection of complications due to surgical sponges left in abdomen

The identification of surgical sponges left in the abdomen and their complications (gossypiboma) creates difficult diagnostic problems in the absence of radio-opaque markers. The phlogistic septic or aseptic reaction to the presence of a foreign body produces nonspecific symptoms and may vary according to the site of the lesions and its relationship with contiguous viscera. Plain abdomen films and the barium meal give some information (mainly topographic), but are usually insufficent for correct diagnosis. As proved by the three case reports discussed, US images (strongly attenuating mass with intense acoustic shadows in a fluid collection) and especially the CT images (mass containing a striped, spotted and whirlike pattern) may be highly indicative, permitting correct preoperative diagnosis