Asymptomatic intrahepatic gossypiboma incidentally discovered: A case report

TL;DR

A 63-year-old woman had a rare case of an asymptomatic surgical sponge left in her liver, diagnosed through imaging and managed without surgery.

Contribution

This case report highlights the rare occurrence of asymptomatic intrahepatic gossypiboma and its diagnostic challenges.

Findings

The lesion showed fat content, peripheral enhancement, and internal calcifications on imaging.

The patient remained asymptomatic, leading to a decision for conservative management.

Multimodal imaging was crucial for accurate diagnosis and management guidance.

Abstract

Gossypiboma, also known as textiloma, refers to a retained surgical sponge or textile material left in the body following a surgical procedure. Intrahepatic localization is extremely rare and can mimic various hepatic lesions, posing a diagnostic challenge, particularly in asymptomatic patients. We report the case of a 63-year-old woman with a history of cholecystectomy and hepatic cyst surgery, who was referred for routine follow-up after a spontaneously resolved episode of jaundice. Laboratory investigations were unremarkable. Magnetic resonance cholangiopancreatography (MRCP) revealed mild biliary dilation without obstruction and identified a well-defined heterogeneous lesion at the surgical margin. The lesion exhibited characteristic imaging features across multiple modalities, including fat content, peripheral enhancement, and internal calcifications. Based on these findings and the patient’s surgical history, a diagnosis of intrahepatic gossypiboma was established. As the patient remained asymptomatic, a multidisciplinary team opted for conservative management with clinical and radiological follow-up. This case emphasizes the importance of considering gossypiboma in the differential diagnosis of hepatic masses in patients with a history of abdominal surgery, and highlights the essential role of multimodal imaging in achieving an accurate diagnosis and guiding appropriate management.

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