TY - JOUR AU - Abdul Naeem, Abdul Naeem AU - Maria Aziz, Alia Mir, Hamid Sial, Muhammad Mudassir Shafiq, Iram Arshad, Maria Aziz, Alia Mir, Hamid Sial, Muhammad Mudassir Shafiq, Iram Arshad PY - 2022/10/25 Y2 - 2024/03/28 TI - Emergency Presentation of Abdominal Pain with Unusual Etiology JF - Journal of Rawalpindi Medical College JA - JRMC VL - 26 IS - 2 SE - Case Reports DO - 10.37939/jrmc.v26i2.1832 UR - https://journalrmc.com/index.php/JRMC/article/view/1832 SP - AB - <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> ER -