The tendency for a foreign body, whether hard like forceps, or soft like
gauze pads, to erode its way into the intestine is very remarkable. Thus
Gifford operated on a patient with intestinal obstruction; an impacted
mass was felt in the ileum, it was extracted through an incision in the
gut and proved to be a pad of cotton-wool enveloped in gauze. She
recovered. Three months previously this woman had undergone abdominal
myomectomy.
Another source of risk to patients is the practice or habit of packing
the pelvic recesses with strips of gauze temporarily, either with the
hope of controlling oozing, or to serve as a drain. I have long
abandoned this habit. The disadvantage of gauze stuffing which needs
consideration in this section is the risk that some portion, or the
whole of it, is sometimes left in the wound. Examples are known where
long strips of ‘gauze stuffing’, sometimes amounting to a yard or more,
have been passed through the anus a year after the operation. Many
intractable sinuses have had a forgotten piece of gauze as the cause of
their persistence.
A woman had cœliotomy performed for peritonitis, the consequence of
criminal abortion; she had a long convalescence due to an intractable
sinus. Eventually the patient was thought to have tuberculous disease of
the appendages, and a mass, formed mainly by the Fallopian tube, was
removed. The walls of the tube were intact, but when slit open the tube
was found to contain a small gauze tampon (Kouwer).
The isolated records relating to foreign bodies left in the abdomen are
very numerous. Thus Wilson in 1884 was able to collect twenty-eight
cases from periodical literature and personal reports from friends. An
interesting discussion took place on the reading of a paper on this
subject before an American gynæcological society, by R. W. Waldo, and
the number of cases related by the members is astonishing and refer to
such things as sponges, dabs, forceps, a strip of iodoform gauze ‘a yard
wide and two yards long’, a pair of spectacles, and ‘an operating-room
towel’, which were left in the abdominal cavity.
The most comprehensive collection of records relating to foreign bodies
left in wounds of all kinds has been made by F. von Neugebauer; they
amount to 195.
REFERENCES
GIFFORD, G. T. _British Medical Journal_, 1907, ii. 1042.
KOUWER, PROF. _Zentralbl. für Gynäk._, 1907, xxxi. 1447.
MACLAREN, A. _Annals of Surgery_, 1896, xxiv. 365.
NEUGEBAUER, F. V. _Monatsschriften für Geburtsh. u. Gyn._, 1900, Bd. xi,
821, 933. _Zentralbl. für Gynäk._, 1904, xxviii. 65.
STEWART, J. E. F. _Australian Medical Gazette_, 1906, xxv. 446.
WALDO, R. W. _American Journal of Obstetrics_, 1906, liv. 553.
WILSON, H. P. C. _Trans. American Gynecological Society_, 1884, ix. 94.
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