Gossypiboma-Induced Acute Abdomen Highlighting the Importance of Surgical Safety Protocols: A Case Report.

Gossypiboma, the medical term for a retained surgical sponge, is a rare but serious postoperative complication, accounting for nearly 50% of malpractice claims related to retained foreign bodies. Despite its importance, it is often underreported due to medicolegal concerns. Clinical manifestations include abdominal pain, nausea, and vomiting, often necessitating surgical intervention. A 56-year-old African male presented with small bowel obstruction 2 months post-appendicectomy. CT imaging suggested small bowel obstruction without a clear etiology. Exploratory laparotomy revealed a retained surgical gauze within a perforated ileal segment, managed via resection and anastomosis with uneventful recovery. The diagnosis was delayed because the gauze did not contain a radio-opaque marker, making it difficult to detect on imaging. Gossypiboma can lead to severe complications such as adhesions and bowel perforation. Although spontaneous expulsion may occur, surgical removal is often required. Prevention remains the best approach, through meticulous surgical sponge counts, use of radio-opaque markers, intraoperative imaging, and advanced tracking technologies. This case underscores the importance of strict adherence to surgical safety protocols, which can prevent such avoidable events and enhance better patient outcomes.