Hondrium (arrow).gossypiboma by a number of authors. The internal whirllike or spongiform pattern containing air bubbles may be the most characteristic sign.two,9 The radiopaque marker strip if present is seen as a thin, wavy, or crumpled metallic density within the mass, as in our case.two,four Calcification of the wall with the mass could also be observed on CT.two CT findings of gossypiboma could often be indistinguishable from those of an intraabdominal abscess.two Likewise, CT findings of gossypiboma could from time to time be indistinguishable from those of fecaloma, hematoma, abscess, and tumor. Fecalomas on CT are noticed as intraluminal colonic masses, using a spotted look, lacking a definite capsule. The differentiation of intraluminal gossypiboma (as in our case) from fecaloma could have already been challenging within the absence of the radiopaque marker and the fistula. Early postoperative hematomas are slightly hyperdense, with attenuation values of 50 to 80 HU, owing to proteinaceous blood products and are observed to resolve on followup studies. Intraabdominal abscess is noticed as a hypodense area of fluid attenuationInt Surg 2014;having a thick, welldefined, enhancing wall. If gas is present within an abscess, it produces an air luid level as an alternative to the spongiform or whirllike pattern characteristic of gossypiboma. On the other hand, abscess may also result as a complication of gossypiboma. Gossypiboma may also present as a palpable abdominal mass in patients having a previous history of laparotomy, as a result mimicking an abdominal tumor. The observation of a mass with sturdy acoustic shadowing on ultrasound and classic, central whorled pattern of gas inside the mass, using a thick, enhancing capsule and central nonenhancing locations on CT will aid in the differentiation of gossypiboma from abdominal tumor.Bis(2-(2-methoxyethoxy)ethyl)amine structure A retained sponge normally appears as a softtissuedensity mass with a thick, welldefined capsule having a whorled internal configuration on T2weighted imaging on magnetic resonance imaging (MRI).2,four Gossypiboma is noticed as a wellcircumscribed mass having a hyperintense center along with a peripheral hypointense rim on T2weighted pictures, showing sturdy peripheralrim enhancement on contrastenhanced T1weighted images. The radiopaque markers observed on Xrays and CT scans are usually not produced out on MRI since the impregnated barium sulphate filaments don’t have any magnetic house.14 In our case, it might be inferred that the surgical sponge retained throughout the preceding surgery for cholecystectomy could have steadily eroded the adjoining walls in the proximal duodenum and transverse colon producing a fistulous tract and therefore migrated intraluminally. The high stress within the colon could push the colonic contents into the duodenum where the pressure is low, resulting in feculent vomiting.3-Hydroxy-4-methylbenzonitrile web Having said that, in our case, there was no feculent vomiting as the surgical sponge was plugging the fistula tract tightly.PMID:24818938 Retained surgical foreign bodies (RSFB) can cause important medical and legal complications between the patient along with the medical professional and have an estimated incidence of roughly 0.three to 1.0 per 1000 instances. RSFB can lead to the surgeon facing charges of health-related negligence, thereby rising the hospital expenses for unnecessary legal tangles and compensation. Also, it affects the reputation in the surgeon and contributes to unnecessary morbidity to the patient, which can be potentially avoidable.15 The very best method to prevent RSFB is usually to avoid its occurrence. The unique approaches to prevent such events are to accurately count all the.