Abstract
A 63-year-old female patient presented with complaints of epigastric pain for 2 months
associated with postprandial fullness and early satiety. She gave history of open
cholecystectomy 2 years back at a peripheral hospital. Her general physical and systemic
examinations were within normal limits. Her routine investigations including hemogram,
liver and renal biochemistries, and ultrasound abdomen were normal. She had received
multiple courses of oral proton pump inhibitors, prokinetics, antacids, and antispasmodics
but had no relief. In view of her persistent complaint and age more than 60 years,
her esophagogastroduodenoscopy (EGD) was planned. Her EGD revealed deeply embedded
large gauze piece in the posterior wall of the first part of duodenum. Her contrast-enhanced
computed tomography revealed mottled appearance in first part of duodenum, which is
nonmobile in subsequent images suggestive of gossypiboma. A final diagnosis of gossypiboma
with partial migration of gauge into duodenal lumen was made. Endoscopic removal was
not attempted in view of possible risk of perforation and patient shifted to the department
of surgery for further management.
Keywords
dyspepsia - endoscopy - foreign body - gossypiboma - pain abdomen
