Retained Surgical Items in Inguinal Canal: A Case Report and Literature Review

Authors

  • Amer Hashim Al Ani Department of General Surgery, Sheikh Khalifa Medical City, Ajman, United Arab Emirates
  • Mohammad Bakri Hammami College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
  • Obaidah M. Mukhles Adi College of Medicine, University of Sharjah, Sharjah, United Arab Emirates

DOI:

https://doi.org/10.3889/oamjms.2018.377

Keywords:

Retained surgical items, inguinal canal, Foreign bodies, case report, Retained Gauze, surgical complications

Abstract

BACKGROUND: Retained surgical items (RSI) are rare medical challenges with serious complications and medicolegal implications. Knowledge and preventive measures for these rare events are currently not sufficient to limit their increasing incidence. Gauzes and sponges constitute most of RSI. Forceps, needles and pins may be found too. Diagnosis of these events is challenging and often missed due to nonspecific clinical findings.

PRESENTATION OF CASE: We present here a 49-year-old patient who presented to the clinic with a history of chronic scrotal sinus on the same side of a repeatedly repaired inguinal hernia 4 months before admission. He underwent exploration of the inguinal canal as elective surgery. Exploration of the inguinal canal revealed missed surgical gauze left during the previous hernia repair. The gauze was removed, and the inguinal canal was repaired. The postoperative period was uncomplicated.

CONCLUSION: Retained surgical items are completely preventable near-events. Although they are rare entities, clinicians must have a high index of suspicion for any postoperative, in patients presenting with pain, sinus or palpable masses.

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References

Ugochukwu AI, Edeh AJ. Retained intra-abdominal artery forceps–An unusual cause of intestinal strangulation. North American journal of medical sciences. 2011; 3(7):339. https://doi.org/10.4297/najms.2011.3339 PMid:22540110 PMCid:PMC3336885

Elsharydah A, Warmack KO, Minhajuddin A, Moffatt-Bruce SD. Retained surgical items after abdominal and pelvic surgery: Incidence, trend and predictors-observational study. Annals of medicine and surgery. 2016; 12:60-4. https://doi.org/10.1016/j.amsu.2016.11.006 PMid:27895909 PMCid:PMC5121141

Hempel S, Maggard-Gibbons M, Nguyen DK, Dawes AJ, Miake-Lye I, Beroes JM, Booth MJ, Miles JN, Shanman R, Shekelle PG. Wrong-site surgery, retained surgical items, and surgical fires: a systematic review of surgical never events. JAMA surgery. 2015; 150(8):796-805. https://doi.org/10.1001/jamasurg.2015.0301 PMid:26061125

Stawicki SP, Moffatt-Bruce SD, Ahmed HM, Anderson III HL, Balija TM, Bernescu I, Chan L, Chowayou L, Cipolla J, Coyle SM, Gracias VH. Retained surgical items: a problem yet to be solved. Journal of the American College of Surgeons. 2013; 216(1):15-22. https://doi.org/10.1016/j.jamcollsurg.2012.08.026 PMid:23041050

Oluwole O, Akinnagbe AM, Nwana EJ, Ogolekwu I, Yilkudi M. Gossypiboma: a cause of iatrogenic fecal entero-cutaneous fistula. Journal of Medicine in the Tropics. 2015; 17(1):34. https://doi.org/10.4103/2276-7096.148694

Stawicki SP, Evans DC, Cipolla J, Seamon MJ, Lukaszczyk JJ, Prosciak MP, Torigian DA, Doraiswamy VA, Yazzie NP, Gunter Jr OL, Steinberg SM. Retained surgical foreign bodies: a comprehensive review of risks and preventive strategies. Scandinavian Journal of Surgery. 2009; 98(1):8-17. https://doi.org/10.1177/145749690909800103 PMid:19447736

Suwatanapongched T, Boonkasem S, Sathianpitayakul E, Leelachaikul P. Intrathoracic gossypiboma: radiographic and CT findings. The British journal of radiology. 2005; 78(933):851-3. https://doi.org/10.1259/bjr/61657645 PMid:16110111

Asuquo ME, Ogbu N, Udosen J, Ekpo R, Agbor C, Ozinko M, Emelike K. Acute abdomen from gossypiboma: A case series and review of literature. Nigerian Journal of Surgical Research. 2006; 8(3-4). https://doi.org/10.4314/njsr.v8i3-4.54901

Agha RA, Fowler AJ, Rammohan S, Barai I, Orgill DP and the PROCESS Group. The PROCESS Statement: Preferred Reporting of Case Series in Surgery. International Journal of Surgery 2016; 36(Pt A):319-323.

Chana-Rodríguez F, Ma-anes RP, Rojo-Manaute J, Moran-Blanco LM, Vaquero-Martín J. Suppl 1: M7: Retained Sponge: A Rare Complication in Acetabular Osteosinthesis. The open orthopaedics journal. 2015; 9:321. https://doi.org/10.2174/1874325001509010321 PMid:26312116 PMCid:PMC4541466

Gawande AA, Studdert DM, Orav EJ, Brennan TA, Zinner MJ. Risk factors for retained instruments and sponges after surgery. New England Journal of Medicine. 2003; 348(3):229-35. https://doi.org/10.1056/NEJMsa021721 PMid:12529464

Yorke J, Agbeko E, Amoah G, Abantanga FA. Case Report: Intestinal Obstruction Secondary to an Intra-Abdominal Foreign Body. Journal of Medical and Biomedical Sciences. 2013; 2(4):1-5. https://doi.org/10.4314/jmbs.v2i4.1

Moffatt-Bruce SD, Cook CH, Steinberg SM, Stawicki SP. Risk factors for retained surgical items: a meta-analysis and proposed risk stratification system. journal of surgical research. 2014; 190(2):429-36. https://doi.org/10.1016/j.jss.2014.05.044 PMid:24953990

Stawicki SP, Cook CH, Anderson III HL, Chowayou L, Cipolla J, Ahmed HM, Coyle SM, Gracias VH, Evans DC, Marchigiani R, Adams RC. Natural history of retained surgical items supports the need for team training, early recognition, and prompt retrieval. The American Journal of Surgery. 2014; 208(1):65-72. https://doi.org/10.1016/j.amjsurg.2013.09.029 PMid:24524864

Freitas PS, Silveira RC, Clark AM, Galvão CM. Surgical count process for prevention of retained surgical items: an integrative review. Journal of clinical nursing. 2016; 25(13-14):1835-47. https://doi.org/10.1111/jocn.13216 PMid:27104785

Firstenberg MS, Stawicki SP. Vignettes in Patient Safety-Volume 2, 2018.

O'Connor AR, Coakley FV, Meng MV, Eberhardt S. Imaging of retained surgical sponges in the abdomen and pelvis. American journal of roentgenology. 2003; 180(2):481-9. https://doi.org/10.2214/ajr.180.2.1800481 PMid:12540456

Nasir G. Missed instrument and surgical sponge (gauze and pack). Int J Surg. 2008; 20(1):14-20.

Fabian CE. Electronic tagging of surgical sponges to prevent their accidental retention. Surgery. 2005; 137(3):298-301. https://doi.org/10.1016/j.surg.2004.10.003 PMid:15746781

Published

2018-11-23

How to Cite

1.
Al Ani AH, Hammami MB, Adi OMM. Retained Surgical Items in Inguinal Canal: A Case Report and Literature Review. Open Access Maced J Med Sci [Internet]. 2018 Nov. 23 [cited 2024 Apr. 26];6(11):2165-7. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2018.377

Issue

Section

C- Case Reports