• endoscopic ultrasound fine‐needle‐aspiration
• gossypiboma
• polarized light microscope
• pseudosubmucosal tumor
• retained surgical sponge

• canine
• gossypiboma
• omental torsion
• whirl sign

• Dogs
• Animals
• Female
• Torsion Abnormality/veterinary
• Torsion Abnormality/diagnostic imaging
• Torsion Abnormality/surgery
• Torsion Abnormality/etiology
• Dog Diseases/etiology
• Dog Diseases/diagnostic imaging
• Dog Diseases/surgery
• Dog Diseases/diagnosis
• Omentum/diagnostic imaging
• Tomography, X-Ray Computed/veterinary
• Foreign Bodies/veterinary
• Foreign Bodies/diagnostic imaging
• Foreign Bodies/complications
• Foreign Bodies/surgery
• Peritoneal Diseases/veterinary
• Peritoneal Diseases/diagnostic imaging
• Peritoneal Diseases/etiology
• Peritoneal Diseases/surgery
• Broad Ligament/diagnostic imaging
• Surgical Sponges/adverse effects
• Surgical Sponges/veterinary

The incidence of gossypiboma is considerably higher in open cavity surgeries, among which cesarean section ranks number one. However, it is difficult to diagnose abdomen or pelvic gossypibomas after cesarean section. We retrospectively analyzed the clinical and imaging data of three pathologically confirmed gossypiboma patients at varied durations after cesarean section. In case one, at four months after cesarean section, a gossypiboma near the small intestine caused fistula and intestinal obstruction. Soft tissue density lesion along the intestinal canal made the “segmental honeycomb sign" and "truncation" with metal markings on the edge on computed tomography (CT). Magnetic sensitivity artifacts were demonstrated as hypointensity on T1 weighted image (T1WI) and T2 weighted image (T2WI), while hyperintensity was seen on the diffusion weighted image (DWI). In case two, a gossypiboma in the peritoneal and intestinal space was revealed with MRI at 18 months after cesarean section. It was featured as a cystic and solid lesion, with "vortex like sign" and obvious ring enhancement on contrast-enhanced MRI scan. In case three, five years after cesarean section, a mass was palpated in the right middle and lower abdomen. MRI revealed a round mass of T1 hypointensity with mixed T2 signal, as well as swirling hypointensity in T2WI, T2WI-fat suppression (FS), and DWI. In CT and MRI examinations for suspected gossypiboma after cesarean section, "honeycomb sign" and "vortex like sign" are the characteristic appearances; gauze translocated into the intestine may show the "truncation sign". Accurate diagnosis is based on the surgery history, symptoms, and imaging features.

• abdominal
• computed tomography
• diagnosis
• gossypboma
• magnetic resonance imaging

This pictorial essay depicts normal appearances, complications and residual or recurrent disease on fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) studies in the postsurgical and postprocedural setting, other than head and neck malignancy. Reading and reporting FDG PET/CT in this scenario is daunting due to the multiple confounding false positives seen during this period. This article which is the second part in this series will familiarize the readers with the normal appearance and pitfalls seen in FDG PET/CT studies in thoracic and abdominopelvic malignancies during the postoperative and postprocedural period so as to avoid misinterpretations.

• Contrast-enhanced
• false-positives
• fluorodeoxyglucose positron emission tomography/computed tomography
• pitfalls
• postoperative
• postsurgical
• recurrence

• Computed Tomography
• Gossypiboma
• Radiography
• Retained surgical sponge
• Surgery
• Ultrasonography

• abdomen
• foreign bodies
• pelvis
• retained surgical sponge
• ultrasonography

• Abdomen/diagnostic imaging
• Adult
• Female
• Foreign Bodies/diagnostic imaging
• Foreign Bodies/surgery
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Pelvis/diagnostic imaging
• Postoperative Complications/diagnostic imaging
• Retrospective Studies
• Surgical Sponges
• Teratoma/diagnostic imaging
• Tomography, X-Ray Computed
• Ultrasonography/methods

Performed on either an elective or urgent basis, cholecystectomy currently represents the most common abdominal operation due to the widespread use of laparoscopy and the progressively expanded indications. Compared to traditional open surgery, laparoscopic cholecystectomy minimised the duration of hospitalisation and perioperative mortality. Albeit generally considered safe, cholecystectomy may result in adverse outcomes with non-negligible morbidity. Furthermore, the incidence of worrisome haemorrhages and biliary complications has not been influenced by the technique shift. Due to the growing medico-legal concerns and the vast number of cholecystectomies, radiologists are increasingly requested to investigate recently operated patients. Aiming to increase familiarity with post-cholecystectomy cross-sectional imaging, this paper provides a brief overview of indications and surgical techniques and illustrates the expected early postoperative imaging findings. Afterwards, most iatrogenic complications following open, converted, laparoscopic and laparo-endoscopic rendezvous cholecystectomy are reviewed with examples, including infections, haematoma and active bleeding, residual choledocholithiasis, pancreatitis, biliary obstruction and leakage. Multidetector computed tomography (CT) represents the “workhorse” modality to rapidly investigate the postoperative abdomen in order to provide a reliable basis for an appropriate choice between conservative, interventional or surgical treatment. Emphasis is placed on the role of early magnetic resonance cholangiopancreatography (MRCP) and additional gadoxetic acid-enhanced MRCP to provide a non-invasive anatomic and functional assessment of the operated biliary tract.

• Having minimised perioperative mortality and hospital stay, laparoscopy has now become the first-line approach to performing cholecystectomy, even in patients with acute cholecystitis.

• Laparoscopic, laparo-endoscopic rendezvous, converted and open cholecystectomy remain associated with non-negligible morbidity, including surgical site infections, haemorrhage, residual lithiasis, pancreatitis, biliary obstruction and leakage.

• Contrast-enhanced multidetector computed tomography (CT) is increasingly requested early after cholecystectomy and represents the “workhorse” modality that rapidly provides a comprehensive assessment of the operated biliary tract and abdomen.

• Magnetic resonance cholangiopancreatography (MRCP) is the best modality to provide anatomic visualisation of the operated biliary tract and is indicated when biliary complications are suspected.

• Additional gadoxetic acid (Gd-EOB-DTPA)-enhanced MRCP non-invasively provides functional biliary assessment, in order to confirm and visualise bile leakage.

• Cholecystectomy
• Complications
• Computed tomography (CT)
• Laparoscopy
• Magnetic resonance imaging (MRI)

The term gossypiboma refers to a sponge that has been forgotten in the surgical field. It is the most common retained surgical item, and constitutes a continuing problem for surgical safety. We performed a hospital-based study to examine their incidence, root cause, and outcomes, as an effort toward improving prevention.

This retrospective study covered 10 years (2006-2015) and included surgically confirmed cases of abdominal gossypibomas occurring after 45,011 abdominal and gynaecological operations in 2 public hospitals in Lome (Togo). Age, diagnosis, initial surgical procedure, evidence of textile count, and data related to the revision procedure were collected for descriptive analysis.

Fifteen cases of gossypibomas (11 women and 4 men) were recorded. The mean age of the patients was 27 (range 21-55) years. Initial procedures were gynaecological in 11 patients and 5 cases involved an emergency surgery. Evidence of sponge counting was found in 6cases. Gossypiboma was an incidental finding in 1 patient. The average time to onset of symptoms after the initial procedure was 2 months. The gossypiboma was removed within 7 days to 4 years after the initial procedure. Postoperative complications included enterocutaneous fistula in 2 patients, incisional hernia in 2 patients, and wound sepsis in 1 patient. Death occurred in 2 patients (13.3%).

Although rare, the incidence of gossypibomas is still unacceptably high and reveals failures regarding patient safety standards. The associated morbidity and mortality are significant, yet can be reduced by an early diagnosis in the immediate postoperative period. A systematic methodical count of sponges is the cornerstone of prevention, and introducing surgical safety protocols, such as the WHO Safe Surgery Saves Lives checklist, can enhance effectiveness. There is a crucial need for safety-focused policies, which may include a never event reporting system, elaboration of prevention strategies, interventions, and evaluation.

• CT scan
• Complications
• Foreign body reaction
• Gossypiboma
• Laparotomy
• Prevention

• Urological surgery

• computed tomography
• dog
• migration
• spongiform pattern
• textiloma

Many hospitals experience one or more retained surgical instrument events with risk of patient morbidity and medicolegal problems. Identification of retained surgical instrument is important. The radiologists should be familiar with imaging finding of retained surgical instrument. In a 62-year-old female with a retained plastic tube, localized peritoneal infiltration around air-containing tubular structure mimicked acute appendicitis on abdomen computed tomography (CT), one year after laparoscopic cholecystectomy. We reported CT findings of foreign body reaction related to retained Endoloop ligature plastic tube mimicking acute appendicitis.

• Foreign body
• Peritonitis
• Retained surgical instrument

• Small bowel obstruction
• fistula
• swab

• Aged
• Duodenal Diseases/diagnostic imaging
• Duodenal Diseases/etiology
• Duodenal Diseases/surgery
• Female
• Foreign-Body Migration/complications
• Foreign-Body Migration/diagnostic imaging
• Foreign-Body Migration/surgery
• Humans
• Intestinal Obstruction/diagnostic imaging
• Intestinal Obstruction/etiology
• Intestinal Obstruction/surgery
• Radiography
• Surgical Sponges

• Gossypiboma
• Pelvic mass
• Retained surgical swab
• Textiloma

• Computed tomography
• Iatrogenic complication
• Iatrogenic injury
• Implanted devices
• Postprocedural complications
• Surgical foreign bodies

Transmural migrated retained sponges usually impact at the level of the ileo-cecal valve leading to a small bowel obstruction. Once passed through the ileo-cecal valve, a retained sponge can be propelled forward by peristaltic activity and eliminated with feces. We report the case of a 52-year-old female with a past surgical history and recurrent episodes of abdominal pain and constipation. On physical examination, a generalized resistance was observed with tenderness in the right flank. Contrast-enhanced multi-detector computed tomography findings were consistent with a perforated right colonic diverticulitis with several out-pouchings at the level of the ascending colon and evidence of free air in the right parieto-colic gutter along with an air-fluid collection within the mesentery. In addition, a ring-shaped hyperdense intraluminal material was also noted. At surgery, the ascending colon appeared irregularly thickened and folded with a focal wall interruption and a peri-visceral abscess at the level of the hepatic flexure, but no diverticula were found. A right hemi-colectomy was performed and on dissection of the surgical specimen a retained laparotomy sponge was found in the bowel lumen.

• Retained sponge
• Transmural migration
• Multi-detector computed tomography
• Colonic perforation
• Acute abdomen

• Abdominal Pain/etiology
• Colon/pathology
• Contrast Media/chemistry
• Feces
• Female
• Foreign Bodies
• Foreign-Body Migration/complications
• Humans
• Intestinal Perforation/etiology
• Intestinal Perforation/surgery
• Laparotomy
• Middle Aged
• Multidetector Computed Tomography
• Peristalsis
• Surgical Sponges/adverse effects

Retained foreign bodies (RFBs) are a surgical complication resulting from foreign materials accidently left in a patient's body. This review attempts to give an overview of different types of RFBs, problems related to them and their management after the surgical operation. The internet was searched using the Google and Google scholar. In addition, relevant electronic journals from the University's library such as Entrez (including PubMed and PubMed central), Since Direct, Scirus, NIH.gov, Medknow.com, Medscape.com, Scopus, MedHelp.org, Cochrane library, WebMD.com, and World Health Organization Hinari. It shows that the major reasons of RFBs are emergency surgical operation with unplanned changes, patient high body mass index, and poor communication. To prevent this textile material should be radiopaque marked and must be counted once at the start and twice at the conclusion of all surgical procedures. If the count is incorrect, then radiography or manually re-exploration should be performed. Ultrasonography, computerized tomography, magnetic resonance imaging and radio frequency identification are also used in the proper identification of RFBs. Safety practice should be robust and simple enough to protect patient under the most chaotic of circumstances. Proper communication among the personnel participating in surgery aimed at preventing this medical negligence would help in mitigating such errors. Finally, the surgeon should not only follow the standard recommended procedure, but also report cases of RFBs.

• Medical negligence
• Radiography
• Retained foreign bodies

• Foreign body
• Gauze
• Obstruction
• Small intestine
• Textiloma

• Adult
• Diagnosis, Differential
• Female
• Foreign Bodies/diagnosis
• Foreign Bodies/surgery
• Humans
• Neoplasm Recurrence, Local/diagnosis
• Ovarian Neoplasms/diagnosis
• Ovarian Neoplasms/surgery
• Ovariectomy
• Surgical Sponges
• Teratoma/surgery

• Abdomen/surgery
• Delayed Diagnosis
• Diagnosis, Differential
• Diagnostic Imaging
• Foreign Bodies/complications
• Foreign Bodies/diagnosis
• Foreign Bodies/prevention & control
• Foreign Bodies/surgery
• Foreign-Body Migration/complications
• Foreign-Body Migration/diagnosis
• Foreign-Body Migration/prevention & control
• Foreign-Body Migration/surgery
• Humans
• Laparoscopy
• Malpractice/legislation & jurisprudence
• Medical Errors
• Reoperation
• Risk Factors
• Sensitivity and Specificity
• Surgical Sponges

• Abdomen
• Adult
• Female
• Fever of Unknown Origin/etiology
• Fever of Unknown Origin/surgery
• Foreign Bodies/complications
• Foreign Bodies/diagnosis
• Humans
• Medical Errors/adverse effects
• Surgical Sponges/adverse effects
• Tomography, X-Ray Computed

• Diagnosis, Differential
• Foreign Bodies/diagnostic imaging
• Foreign Bodies/surgery
• Foreign-Body Reaction/diagnostic imaging
• Foreign-Body Reaction/surgery
• Humans
• Postoperative Complications/diagnostic imaging
• Postoperative Complications/surgery
• Reoperation
• Surgical Instruments
• Tomography, X-Ray Computed

• Diagnosis, Differential
• Humans
• Peritoneal Diseases/diagnostic imaging
• Peritoneal Diseases/pathology
• Tomography, X-Ray Computed

• Abdomen
• Adult
• Aged
• Female
• Foreign Bodies/diagnosis
• Foreign Bodies/diagnostic imaging
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Pelvis/diagnostic imaging
• Radiography, Abdominal
• Surgical Sponges
• Tomography, X-Ray Computed

• Abdomen/pathology
• Abdominal Neoplasms/diagnosis
• Abdominal Neoplasms/etiology
• Adult
• Female
• Granuloma, Foreign-Body/diagnosis
• Granuloma, Foreign-Body/etiology
• Humans
• Magnetic Resonance Imaging/methods
• Middle Aged
• Pelvic Neoplasms/diagnosis
• Pelvic Neoplasms/etiology
• Pelvis/pathology
• Surgical Sponges/adverse effects