Gossypiboma retroperitoneal diagnosticado siete años después de nefrectomía izquierda: reporte de caso y revisión narrativa
Reporte de caso
DOI:
https://doi.org/10.69825/cienec.v8i33.369Abstract
El gossypiboma, también denominado textiloma, corresponde a la reacción inflamatoria generada por la retención inadvertida de material textil quirúrgico en el organismo. Aunque es una complicación poco frecuente, representa un evento adverso prevenible con implicaciones clínicas y médico-legales relevantes. Presentamos el caso de un paciente masculino de 41 años con antecedente de nefrectomía izquierda realizada siete años antes por hidronefrosis obstructiva secundaria a litiasis renal. Consultó por dolor lumbar izquierdo de seis meses de evolución acompañado de episodios febriles y astenia. La exploración física evidenció dolor a la palpación profunda en flanco izquierdo y cicatriz de lumbotomía previa. Los estudios de laboratorio fueron normales. La tomografía computarizada contrastada mostró una masa retroperitoneal encapsulada en la fosa renal izquierda con patrón espongiforme interno sugestivo de gossypiboma. Se realizó abordaje quirúrgico inicialmente laparoscópico con conversión a lumbotomía debido a fibrosis intensa en el lecho quirúrgico previo. Durante la intervención se identificó y extrajo una compresa quirúrgica retenida encapsulada en tejido inflamatorio y fibrótico. La evolución postoperatoria fue favorable, con alta médica al cuarto día. Este caso resalta la importancia de considerar el gossypiboma en el diagnóstico diferencial de masas retroperitoneales en pacientes con antecedente quirúrgico, así como la relevancia de la tomografía computarizada en su diagnóstico y de la extracción quirúrgica como tratamiento definitivo.
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