@article{Abdul Naeem_Maria Aziz, Alia Mir, Hamid Sial, Muhammad Mudassir Shafiq, Iram Arshad_2022, title={Emergency Presentation of Abdominal Pain with Unusual Etiology}, volume={26}, url={https://journalrmc.com/index.php/JRMC/article/view/1832}, DOI={10.37939/jrmc.v26i2.1832}, abstractNote={<p>Abdominal pain has vast differentials and routine etiologies are diagnosed easily. Difficulty arises with uncommon presentation. This is a case of 28 years old lady presenting to emergency department of Holy Family Hospital, Rawalpindi with worsening abdominal pain, vomiting and loose stools over 2 weeks. Routine examination and workup did not help to find any cause. Ultrasound abdomen suspected matted gut loops with enlarged lymph nodes. CECT abdomen confirmed a non-differentiating tissue collection in right iliac fossa. Later diagnosis of complicated gossybioma (retained gauze surrounded by fibrotic tissue with entero-enteric fistula and fecolith in appendix) was confirmed by laparoscopy that was surgically removed. Conclusion: Gossybioma is infrequent but avoidable complication that needs to be considered by surgeon meticulously especially by swab counting, avoiding staff change over during procedure and consideration in follow up visit.</p>}, number={2}, journal={Journal of Rawalpindi Medical College}, author={Abdul Naeem, Abdul Naeem and Maria Aziz, Alia Mir, Hamid Sial, Muhammad Mudassir Shafiq, Iram Arshad, Maria Aziz, Alia Mir, Hamid Sial, Muhammad Mudassir Shafiq, Iram Arshad}, year={2022}, month={Oct.} }