A Patient With Abnormal Abdominal CT Scan Findings

Gossypiboma (retained surgical sponge)

C. Perform an exploratory laparotomy and excision of the mass

The key to the correct diagnosis is the remote history of a trauma laparotomy and the CT scan scout image that shows the characteristic finding of a radiopaque marker associated with a retained surgical sponge (Figure 2). All surgical sponges are equipped with such a marker, which manifests radiographically as a convoluted hyperdensity. These abdominal lesions may be confused with a gastrointestinal stromal tumor or other gastrointestinal malignancies. Since the lesion appears radiographically to be outside the lumen of the gastrointestinal tract, EGD has no role. Without a confirmed diagnosis of malignancy, laparoscopy with peritoneal washings to identify occult metastases would be premature. An interventional radiology–guided biopsy is unnecessary, given the early recognition of the radiopaque marker associated with gossypiboma.