A 68-year-old man was admitted to the emergency ward presenting with cough and chest pain that had started 3 days earlier. The patient denied fever or other symptoms and had a history of cardiac surgery with myocardial revascularization 1 month before. Physical examination and laboratory findings were unremarkable. Chest computed tomography (CT) showed an elongated heterogeneous mass containing gas bubbles and metallic densities in the anterior, paramediastinal region of the left hemithorax (Figure 1), suggestive of a retained surgical sponge. Surgical exploration revealed a well-encapsulated surgical gauze sponge in the left hemithorax. The patient’s postoperative recovery was uneventful. After 2 years, he remains asymptomatic.
Textiloma (also known as gossypiboma) is the term used to describe a mass in the body composed of a sponge or other retained surgical material surrounded by foreign-body reaction. It is a rare complication following thoracic surgery. CT is the most effective imaging method for the detection of a retained intrathoracic textiloma. Although some cases are clinically silent and discovered only upon routine radiological examination, textilomas can have severe medical consequences, including infection and abscess formation. Surgical treatment is indicated in almost all cases.(1,2)
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Nobre LF, Marchiori E, May F, Carrão AD, Zanetti G, Machado DM. Thoracic textilomas after myocardial revascularisation: typical CT findings. Br J Radiol. Jan 2010;83(985):4–7. https://doi.org/10.1259/bjr/68800282.
Karabulut N, Herek D, Kiroğlu Y. CT features of intrathoracic gossypiboma (textiloma). Diagn Interv Radiol. Jun 2011;17(2):122-4. https://doi.org/10.4261/1305-3825.dir.3120-09.0.