The retained surgical sponge following laparotomy; forgotten at surgery, often forgotten at diagnosis. Our experience.

Retained surgical sponge following laparotomy is an oversight with potentially serious repercussions for the patient, the operating team and the hospital. The diagnosis requires a high index of suspicion as the variety of presentations can easily be confused with commoner postoperative complications. We present 5 cases managed at Ahmadu Bello University Teaching Hospital, Kaduna from 2000-2005 with review of literature to highlight the diagnostic, therapeutic and preventive challenges in this part of the world. A patient presented with intestinal obstruction and severe malabsorption, another, severe intraabdominal sepsis and organ failure which led to death and three with enterocutaneous fistula. Confirmation of retained surgical sponge was made only at surgery in three patients and after expulsion of the sponge per rectum in two. The possibility of retained surgical sponge should be considered as a remote cause of postoperative abdominal symptoms especially if such surgeries have been conducted in peripheral clinics or hospitals in our environment. Surgeons in this country also have a particular duty to ensure that the sponges used during laparotomies are removed and to supervise preventive measures to ensure that they are not retained, as the precarious financial position of our patients make further postoperative investigations and relaparotomy even more difficult