Complete transmural migration of a retained surgical sponge: an atypical case in image mimicking intussusception: A case report.

RATIONALE: Intraluminal migration of a retained surgical sponge causing intestinal obstruction and fistula is extremely rare occurrence.

PATIENT CONCERNS: A case of a 35-year-old male, who complaining a diffuse abdominal pain beginning three days earlier. He also complained of occasional vomiting, nonspecific abdominal pain, and an unintentional 15 kg weight loss during the past 2 years. However, there were no clear findings in previous laboratory work. He had received an open appendectomy approximately 4 years earlier.

DIAGNOSES: Retained surgical sponge.

INTERVENTIONS: A contrast-enhanced CT of the abdomen showed a clear invagination of the small intestine. However, intraoperatively, we could not find an intestinal segment with intussusception. After the adhesive intestine was detached, a jejunal-ileal cross-linked fistula was found. More surprisingly, a retained surgical sponge was found inside the ileal fistula when the cross-linked fistula was detached.

OUTCOMES: The patient was discharged 7 days after surgery.

LESSONS: This is the first report showing an atypical image of a complete transmural migration of a retained surgical sponge mimicking intussusception.