Long-date oblitoma as an incidental finding during laparoscopic hysterectomy: clinical case report

Abstract

The word "oblito" is defined in the dictionary of the Royal Spanish Academy of Language as "foreign body forgotten inside a patient during a surgical intervention" they can be hard like tweezers, needles or soft like gauze and compresses accompanied by different symptoms or be practically asymptomatic. The case of a 49-year-old woman with a history of cesarean section with tubal ligation performed at another institution 10 years ago is reported, who comes to the consultation due to a picture of abnormal uterine bleeding of structural cause due to uterine myomatosis in the transvaginal ultrasound the presence of an enlarged uterus of 11.4x 8.15x 5.5 cm was reported with 2 images suggestive of subserous intramural fibroids, the largest of 6 centimeters in diameter, endometrium of 2 mm, ovaries of normal characteristics. A laparoscopic hysterectomy was performed, during which the presence of a pad formed by a compress that was completely encapsulated by the omentum was observed. The histopathological examination confirmed the presence of a chronic inflammatory process due to a foreign body consisting of suture threads and mesh, ischemic necrosis and a giant cell reaction that encompasses birefringent inorganic material under polarized light. After completion of the scheduled surgery, the clinical evolution was favorable. In addition, she was managed during her hospitalization with analgesia, thromboprophylaxis and antibiotic therapy, observing a notable improvement in her quality of life in her post-surgical control.