A case of Foreign Body Granuloma (Gauze) Suspected by Diagnostic Imagings.

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  • TAKEMOTO Nobuyuki
    Department of Surgery, Higashi Saitama General Hospital Department of Surgery, Omiya Medical Center, Jichi Medical School
  • YAMAMOTO Hiroshi
    Department of Surgery, Higashi Saitama General Hospital Department of Surgery, Omiya Medical Center, Jichi Medical School
  • OKADA Shinichiro
    Department of Surgery, Higashi Saitama General Hospital Department of Surgery, Omiya Medical Center, Jichi Medical School
  • KAI Toshihiro
    Department of Surgery, Omiya Medical Center, Jichi Medical School
  • SEKIGUCHI Katsuya
    Department of Surgery, Higashi Saitama General Hospital
  • KONISHI Fumio
    Department of Surgery, Omiya Medical Center, Jichi Medical School

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  • 興味ある画像を呈した異物による腹腔内肉芽腫の１例

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Abstract

A 62-year-old woman was seen at the hospital, because of epigastric pain in May 1997. These were previous histories of undergoing a distal gastrectomy for peptic ulcer at the age of 19 and caesarian section at the age of 36. A round-shaped mass, 5cm in size, was palpated in the left lower abdomen on a physical examination. She was admitted for further evaluation of the lesion. Abdominal ultrasonography (US) showed linear high-echoes in a low-echoic mass, whose border was clear. CT scan revealed a well-encapsulated low density mass. Upon laparotomy, the lesion was located in the mesentery of the small bowel and firmly adhered to it. A partial resection of the small bowel including the tumor was performed. Pathological examination finally demonstrated a granulomatous mass with chronically inflammatory changes caused by a retained surgical gauze. The accurate pre-operative diagnosis is considered to be difficult in such cases even by making the most use of imagings. However, both unusual US and/or CT findings of the lesion wlth previous surgical history help us to suspect the diagnosis of retained surgical materials.

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