Gossypi = cotton
Risk factors for sponge or towel retention:
(1) major open surgery (thoracic, abdominal, cardiovascular, orthopedic, etc)
(2) error in sponge count after surgery
(3) emergency surgery or surgery with major intraoperative problems, especially bleeding
(4) inexperienced surgeon and/or support team
(5) failure to check the operative site prior to closure
Surgical sponges and towels have a radio-opaque marker sewn in which allows visualization on imaging studies. However, these may disintegrate or break down over time, or a sponge without a marker may be used inadvertently.
The presentation may be soon after surgery or delayed for weeks, months or years.
Additional presentations may include:
(1) abscess
(2) fistula
(3) mass mistaken for tumor
The sponge may migrate into a variety of unexpected places:
(1) across the diaphragm
(2) into the urinary bladder
(3) into the intestinal lumen (often associated with an incision in the bowel wall)
