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A case of gossypiboma mimicking intrahepatic cholangiocarcinoma.
[cholangiocarcinoma]
A
gossypiboma
refers
to
a
cotton-based
foreign
body
left
inadvertently
in
the
human
body
following
a
surgical
procedure
.
Although
a
rare
event
,
they
tend
to
be
found
in
the
abdomen
but
few
are
known
to
be
intrahepatic
.
We
report
the
case
of
a
44
year
-old
man
who
presented
with
recurrent
episodes
of
jaundice
and
cholangitis
,
on
a
background
of
a
right
hepatectomy
for
hydatid
cyst
excision
20
years
previously
.
This
case
was
discussed
at
our
hepatobiliary
multidisciplinary
team
meetings
on
several
occasions
and
a
presumed
diagnosis
of
intrahepatic
cholangiocarcinoma
was
made
.
Biopsies
of
the
mass
had
purely
shown
inflammation
and
remained
inconclusive
.
It
was
decided
that
the
patient
should
undergo
a
complete
extended
right
hepatectomy
with
resection
and
reconstruction
of
the
left
branch
of
the
portal
vein
.
On
attempting
to
obtain
intraoperative
frozen
section
specimens
prior
to
resection
,
open
excision
revealed
two
large
swabs
encased
in
a
calcified
cavity
.
Removal
of
the
swabs
resulted
in
resolution
of
the
mass
and
obstructive
symptoms
.
Gossypiboma
should
be
a
rare
differential
diagnosis
in
all
patients
following
a
laparotomy
presenting
with
obstructive
symptoms
,
particularly
in
countries
where
strict
surgical
protocols
may
not
be
in
place
.
This
case
also
highlights
the
need
to
perform
an
intraoperative
biopsy
in
any
uncertain
case
of
a
liver
lesion
as
we
have
shown
that
an
extensive
operation
with
its
increased
morbidity
can
occasionally
be
avoided
.
Diseases
Validation
Diseases presenting
"purely shown inflammation"
symptom
cholangiocarcinoma
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