گزارش یک مورد کیست بزرگ multiloculated به‌دنبال جا ماندن لانگ گاز در عمل جراحی سزارین

نوع مقاله : گزارش مورد

نویسندگان

1 استادیار گروه زنان و مامایی، مرکز تحقیقات سلامت و بیماری‌های زنان، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

2 استادیار گروه جراحی، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

3 استادیار گروه بیهوشی، دانشکده پزشکی، دانشگاه علوم پزشکی گرگان، گلستان، ایران.

4 مربی گروه بیهوشی، مرکز تحقیقات مؤلفه‌های اجتماعی نظام سلامت، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

10.22038/ijogi.2024.75658.5893

چکیده

مقدمه: اصطلاح  Gossypibomaبرای توصیف اسفنج­های جراحی یا گازهایی است که پس از یک عمل جراحی در بدن بیمار باقی می­مانند. در مطالعه حاضر یک مورد کیست بزرگ multiloculate به‌دنبال جا ماندن لانگ گاز در عمل جراحی سزارین گزارش می‌شود.
معرفی بیمار: بیمار خانمی 37 ساله در سن حاملگی 38 هفته به‌علت دردهای زایمانی و به‌دنبال پارگی کیسه آب، تحت عمل جراحی سزارین قرار گرفت و نوزاد زایمان شد و بیمار بدون هیچ‌گونه عارضه‌ای ترخیص شد. بیمار حدوداً 5 ماه بعد به‌علت درد پهلوی راست مراجعه کرد. در سونوگرافی در طرف راست کیست بزرگ multiloculate در لگن و کمی بالاتر از آن گزارش شده بود. جراح عمومی درخواست سی‌تی اسکن را داده بود که جواب مبنی بر توده کیست ماننده در طرف راست حفره شکمی با تجمع مایع و گاز بود. در نهایت پس از ماه‌ها انتظار برای انجام تصویربرداری‌های مختلف، تصویر X-ray، جسم خارجی لانگ گاز را بعد از 11 ماه تشخیص داده شد که از این جهت بیمار، بستری و تحت عمل جراحی قرار گرفت و سپس کیست که متشکل از لانگ گاز و دیواره ضخیمی از آمنتوم در اطراف آن بود، آزاد و خارج شد. یک هفته بعد بیمار دارای حال عمومی بدون مشکل بود.
نتیجه ­گیری: عدم پیشگیری از بروز Gossypiboma، یکی از موارد بسیار مهمی است که سبب بروز عوارض بسیار جدی مانند کیست­ های بزرگ در بیماران می‌شود. بنابراین تمام پرسنل اسکراب و سیرکولار اتاق عمل باید تمام دقت خود را در شمارش ابزار مورد استفاده در جراحی بکار برند. 

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

A case report of a large multiloculated cyst following the retention of a long gas in cesarean section

نویسندگان [English]

  • Farideh Mogharab 1
  • Lohrasb Taheri 2
  • Mansour Deilami 3
  • navid kalani 4
1 Assistant professor, Department of Obstetrics and Gynecology, Women's Health and Diseases Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
2 Assistant professor, Department of Surgery, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
3 Assistant Professor, Department of Anesthesiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
4 Instructor, Department of Anesthesiology, Research Center for Social Determinants of Health, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
چکیده [English]

Introduction: The term gossypiboma is used to describe surgical sponges or gauzes that remain in the patient's body after a surgery. The present study reports a case of a large multiloculated cyst following the retention of a long gas in an emergency cesarean section.
Case Presentation: A 37-year-old female patient underwent a cesarean section at a gestational age of 38 weeks due to labor pains and rupture of the membranes, and the baby was delivered and the patient was discharged without any complications. About 5 months later, the patient referred because of right flank pain. In the ultrasound, a large multiloculate cyst was reported on the right side of the pelvis and slightly above it. The general surgeon requested a CT scan, which revealed a cyst-like mass on the right side of the abdominal cavity with fluid and gas accumulation. Finally, after months of waiting for various imaging, the X-ray image diagnosed the foreign body of long gauze after 11 months. For this reason, the patient was hospitalized and underwent surgery, and then the cyst, which consisted of long gas and a thick wall of ammentum around it, was released and removed. A week later, the patient had a general condition without problems.
Conclusion: Failure to prevent the occurrence of Gossypiboma is one of the most important issues that causes serious complications such as large cysts in patients. Therefore, all scrub and circular personnel in the operating room should use all their attention when performing instrument counts.

کلیدواژه‌ها [English]

  • Cesarean section
  • Cyst
  • Emergency
  • long gas

مراجع

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مجله زنان، مامایی و نازایی ایران
دوره 27، شماره 2
اردیبهشت 1403
صفحه 71-76

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