A Case Report of Retained Foreign Body in the Terminal Ileum Following Cholecystectomy

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Published Sep 30, 2025
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Vol. 4 No. 03 (2025): September

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Asadullah Hussainzai
Nangarhar University
Sayed Ahmad shah Akbar
Nangarhar University
Niamatullah Darman
Nangarhar University
Sayed Zekria Hashimi
Nangarhar University
Muhammad Ishaq Shinwary
Nangarhar University

Abstract

Background: Retained foreign body, is a rare but serious postoperative complication that often arises after emergency or prolonged surgeries. Its clinical presentation varies widely, from asymptomatic to life-threatening complications such as obstruction, fistula, or infection. Despite improvements in surgical protocols, retained foreign body remains a significant medicolegal and diagnostic challenge, particularly in resource-limited settings.


Case Presentation: We report a case of a 28-year-old female patient who presented with chronic abdominal pain, vomiting, weight loss, and failure to thrive, six weeks after undergoing an open cholecystectomy. Radiological investigations suggested small bowel obstruction, and exploratory laparotomy revealed a retained surgical sponge (gossypiboma) lodged in the terminal ileum near the ileocecal valve. The sponge had caused a localized inflammatory reaction and partial intestinal obstruction. The foreign body was surgically removed, and the patient recovered uneventfully.


Discussion: Retained foreign body can mimic a wide range of gastrointestinal disorders and often leads to delayed diagnosis due to nonspecific symptoms. Transmural migration of sponges into the bowel lumen is a rare but documented phenomenon, typically occurring in surgeries like cholecystectomy, cesarean section, and hysterectomy. This case aligns with other documented reports of gossypiboma-induced small bowel obstruction, emphasizing the importance of high clinical suspicion in postoperative patients with unexplained symptoms.


Conclusion: This case underscores the critical need for rigorous surgical count protocols and the use of radiopaque materials to prevent retained foreign bodies. Early recognition and surgical intervention remain key to reducing associated morbidity and legal implications.

Keywords

Abdominal pain, Cholecystectomy, Enterotomy, Gossypiboma, Retained, foreign, body

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Author Biographies

Asadullah Hussainzai, Nangarhar University

Lecturer, Department of General surgery, Faculty of Medicine, Nangarhar University, Nangarhar Afghanistan.

Sayed Ahmad shah Akbar, Nangarhar University

Lecturer, Department of urology, Faculty of Medicine, Nangarhar University, Nangarhar Afghanistan

Niamatullah Darman, Nangarhar University

Lecturer, Department of Ear, Nose and Throat, Faculty of Medicine, Nangarhar University, Nangarhar Afghanistan

Sayed Zekria Hashimi, Nangarhar University

Lecturer, Department of Public health and preventive medicine, Faculty of Medicine, Nangarhar University, Afghanistan

Muhammad Ishaq Shinwary, Nangarhar University

Lecturer, Department of Public health and preventive medicine, Faculty of Medicine, Nangarhar University, Afghanistan.

How to Cite
Hussainzai, A., Akbar, S. A. shah, Darman, N., Hashimi, S. Z., & Shinwary, M. I. (2025). A Case Report of Retained Foreign Body in the Terminal Ileum Following Cholecystectomy. Nangarhar University International Journal of Biosciences, 4(03), 40–46. Retrieved from https://nuijb.nu.edu.af/index.php/nuijb/article/view/406

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