z-logo
open-access-imgOpen Access
Colonic perforation by a transmural and transvalvular migrated retained sponge: Multi-detector computed tomography findings
Author(s) -
Luigi Camera,
Marco Sagnelli,
Paolo Guadagno,
Pier Paolo Mainenti,
Teresa Marra,
Maria Scotto di Santolo,
Landino Fei,
Marco Salvatore
Publication year - 2014
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v20.i15.4457
Subject(s) - medicine , ascending colon , perforation , lumen (anatomy) , abscess , mesentery , laparotomy , radiology , computed tomography , diverticulitis , surgery , anatomy , materials science , punching , metallurgy
Transmural migrated retained sponges usually impact at the level of the ileo-cecal valve leading to a small bowel obstruction. Once passed through the ileo-cecal valve, a retained sponge can be propelled forward by peristaltic activity and eliminated with feces. We report the case of a 52-year-old female with a past surgical history and recurrent episodes of abdominal pain and constipation. On physical examination, a generalized resistance was observed with tenderness in the right flank. Contrast-enhanced multi-detector computed tomography findings were consistent with a perforated right colonic diverticulitis with several out-pouchings at the level of the ascending colon and evidence of free air in the right parieto-colic gutter along with an air-fluid collection within the mesentery. In addition, a ring-shaped hyperdense intraluminal material was also noted. At surgery, the ascending colon appeared irregularly thickened and folded with a focal wall interruption and a peri-visceral abscess at the level of the hepatic flexure, but no diverticula were found. A right hemi-colectomy was performed and on dissection of the surgical specimen a retained laparotomy sponge was found in the bowel lumen.

The content you want is available to Zendy users.

Already have an account? Click here to sign in.
Having issues? You can contact us here