Pieces of surgical gauze and surgical instruments employed for the duration of an operation, repeat the count in case of any doubt to a member with the operating team, inspect the operativeSISTLAGOSSYPIBOMA CAUSING COLODUODENAL FISTULAFig. 3 A 37yearold woman, post opencholecystectomy, with gossypiboma and coloduodenal fistula. (A) Nonenhanced axial CT scan of the abdomen showing intraluminal hypodense gascontaining mass (arrow) inside the proximal transverse colon, with metallic density (arrowhead) in the mass constant with surgical sponge obtaining radiopaque marker strip. (B) Contrastenhanced (venous phase) axial CT scan on the abdomen showing intraluminal hypodense gascontaining mass (arrow) inside the proximal duodenum along with the fistulous tract (arrowhead). (C) Contrastenhanced (venous phase) coronal reformatted CT image of the abdomen showing an intraluminal hypodense gascontaining mass (arrow) within the proximal transverse colon with metallic density (). A 2.5cm fistulous tract (arrowhead) is observed between the proximal duodenum as well as the proximal transverse colon. (D) Contrastenhanced (venous phase) sagittal reformatted CT image with the abdomen displaying an intraluminal hypodense gascontaining mass (arrow) inside the proximal duodenum and proximal transverse colon with metallic density (). A two.5cm fistulous tract (arrowhead) is seen between the proximal duodenum and the proximal transverse colon. [Siemens Sensation 64 Multislice CT, 250 mAs, 120 kV, 2mm slices: oral contrast30 mL meglumine diatrizoate (Urograffin) 60 diluted in 1 L water; intravenous contrast: meglumine diatrizoate (Urograffin, Erlangen, Germany) 60 , 50mL bolus.]field thoroughly prior to closure, use radiopaque markers, and Xray the operative area ahead of and immediately after fascial closure though the patient is still around the operating area table. All these assume unique importance and significance in tough surgeries, which span lots of hours and where a lapse in concentration is expected on the a part of the operating group members. Meticulous consideration ought to be paid to surgery until its completion to prevent such events.ConclusionDiagnosis of gossypiboma will not be straightforward, and delayed diagnosis is usually a surgical trouble. Inadvertently retained sponges are certainly not normally suspected clinically and are subsequently recognized on imaging. Coloduodenal fistula is often a rare presentation of gossypiboma, which could be effectively managed with excision from the fistula with principal duodenal repair.Int Surg 2014;GOSSYPIBOMA CAUSING COLODUODENAL FISTULASISTLA5. Tayildiz I, Aldemir M.2055840-60-1 uses The errors of surgeons: “gossypic boma.1089706-28-4 uses ” Acta Chir Belg 2004;104(1):715 six.PMID:23795974 Arpit N, Abhijit RA, Ranjeet NS, Govind C, Hira P, Bhatgadde VL. Gauze pad inside the abdomen: can you give the diagnosis without the need of realizing the history Accessible at: http://www. jradiology.com/arts/50.pdf. Accessed July 4, 2013 7. Gencosmanoglu R, Inceoglu R. An uncommon result in of compact bowel obstruction: gossypibomacase report. BMC Surg 2003;3:six eight. Manikyam SR, Gupta V, Gupta R, Gupta NM. Retained surgical sponge presenting as a gastric outlet obstruction and duodenoileocolic fistula: report of a case. Surg Now 2002; 32(five):42628 9. Ersoy H, Saygili OB, Yildirim T. Abdominal gossypiboma: ultrasonography and computerized tomography findings. Turk J Gastroenterol 2004;15(1):656 10. Yamato M, Ido K, Izutsu M, Narimatsu Y, Hiramatsu K. CT and ultrasound findings of surgically retained sponges and Fig. four A 37yearold woman post opencholecystectomy with gossypiboma and coloduodenal.