40年前の遺残ガーゼによる傍膀胱異物肉芽腫の1例

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67歳男.40年前の尿管切石術時の遺残ガーゼによる傍膀胱異物肉芽腫例を報告した.ガーゼオーマは医原性であるため報告されにくいが,手術歴のある患者の腹部腫瘤の鑑別診断において忘れてならないものである.既往歴をよく確認し,遺残ガーゼの可能性を念頭に置いて画像の特徴を検討することが,正しい診断につながると考えられたA 67-year-old man complained of vague pain in the lower abdomen persisting over 10 years. A hard mass was palpable just under an operative scar (right Gibson incision for ureterolithotomy performed 40 years previously). In addition to the patient's history and physical examination, abdominal echography, computerized tomography and nuclear magnetic resonance imaging (MRI) were performed and resulted in a preoperative diagnosis of retroperitoneal gauzeoma. The paravesical mass, 7 x 6 x 6 cm in size, was surgically removed, which was an encapsulated granuloma surrounding a surgical sponge. The possibility of foreign body granulomas due to a retained surgical sponge (so-called gauzeomas) should be considered in patients who have a previous history of abdominal operations.