Case Report: A Painful Twist of Fate Due to Intra-abdominal Textiloma - Peer-reviewed Case Report Summary

Sep 29, 2026

Textiloma is a rare but serious retained surgical textile complication that can remain silent for years. The case involves a 38-year-old woman with persistent abdominal pain long after open ovarian cystectomy, with imaging showing a complex pelvic mass, abscess formation, and an enteric fistula. Endoscopic removal of a retained textile in the rectum was followed by generalized peritonitis and emergency laparotomy revealing two retained textilomas and multiple intestinal perforations, ending in septic shock on postoperative day one.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Introduction

Case Presentation

Endoscopic findings

Emergency laparotomy and outcome

Open Peer Review

Conclusion

CASE REPORT Case Report: A Painful Twist of Fate Due to Intra-abdominal Textiloma [version 1; peer review: 1 approved, 1 approved with reservations, 1 not approved] Rakia Siala 1, Mohamed Ali Mseddi 1, Haythem Yacoub2, EYA AZOUZ3, Hajer Hassine 2, Chaima Yacoubi 1, Meriem Hsairi 1, Fatma Trifa 4, Radhia Boubaker4, Nesrine Krifa 2, Sallemi Karim 1, Emna Khemakhem 1, Abdelwaheb Mghirbi4, Amal Bhira4, Yosra Yahia4, Souhir Mestiri2, Rami Guizani 1, Brahim Ghariani 1, Karim Sassi 1, Hamida Maghraoui4, Hela Kchir2, Mohamed Ben Slima 1 1General surgery “B” department, Rabta Hospital, Tunis, Tunis, Tunisia 2Gastroenterology “B” Department, Rabta Hospital, Tunis, Tunis, Tunisia 3 Medical Imaging Department, Rabta Hospital, Tunis, Tunis, Tunisia 4 Emergency department, Rabta Hospital, Tunis, Tunis, Tunisia v1 First published: 19 Sep 2025, 14:947 [https://doi.org/10.12688/f1000research.169895.1](https://doi.org/10.12688/f1000research.169895.1) [Latest published:](Latest published: 04 Dec 2025)[ 04 Dec 2025](Latest published: 04 Dec 2025), 14:947 [https://doi.org/10.12688/f1000research.169895.2](https://doi.org/10.12688/f1000research.169895.2) Abstract Introduction Textiloma refers to a retained surgical textile material within the body after surgery. It is a rare but serious iatrogenic complication that may remain asymptomatic for years. Case Presentation We report a case of a 38-year-old woman with a history of open ovarian cystectomy 15 years earlier, presenting with persistent abdominal pain. Imaging revealed a complex pelvic mass with abscess formation and enteric fistula. Despite interventional drainage and antibiotic therapy, the patient developed signs of sepsis. Endoscopic evaluation revealed a retained surgical textile in the rectum, which was extracted. The patient subsequently developed generalized peritonitis and underwent emergency laparotomy revealing two retained textilomas and multiple intestinal perforations. Despite aggressive surgical intervention, the patient succumbed to septic shock on postoperative day one. Open Peer Review Approval Status 1 2 3 version 2 (revision) 04 Dec 2025 version 1 view view view 19 Sep 2025 1. Faiz Tuma , Central Michigan University College of Medicine, Saginaw, USA 2. Muhammad Nabeel Saddique , King Edward Medical University, Lahore, Pakistan 3. Tetsuya Ishimaru , National Center for Child Health and Development, Setagaya, Japan Any reports and responses or comments on the article can be found at the end of the article. Conclusion Textiloma should be considered in patients with atypical abdominal masses and previous surgical history. Preventive strategies and early recognition are critical to avoid fatal outcomes. Keywords Textiloma, intestinal perforation, peritonitis Corresponding author: Mohamed Ali Mseddi ([mseddibaka@gmail.com](mseddibaka@gmail.com)) Author roles: Siala R: Conceptualization, Supervision, Validation; Mseddi MA: Conceptualization, Writing – Original Draft Preparation, Writing – Review & Editing; Yacoub H: Resources, Supervision; AZOUZ E: Resources, Supervision; Hassine H: Supervision; Yacoubi C: Supervision; Hsairi M: Supervision; Trifa F: Supervision; Boubaker R: Supervision; Krifa N: Supervision; Karim S: Supervision; Khemakhem E: Supervision; Mghirbi A: Supervision; Bhira A: Supervision; Yahia Y: Supervision; Mestiri S: Supervision; Guizani R: Supervision; Ghariani B: Supervision; Sassi K: Supervision; Maghraoui H: Supervision; Kchir H: Supervision; Ben Slima M: Supervision, Validation Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Siala R et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is

FAQs

What is textiloma and why is it clinically important?

Textiloma refers to retained surgical textile material inside the body after an operation. It is rare but serious and can remain asymptomatic for years before causing severe complications.

What diagnostic findings led to identifying the retained surgical textile?

Imaging revealed a complex pelvic mass with abscess formation and an enteric fistula. Endoscopic evaluation later identified a retained surgical textile in the rectum, which was extracted.

How did the patient’s condition progress after extraction?

After endoscopic removal, the patient developed generalized peritonitis and required emergency laparotomy. Surgery revealed two retained textilomas and multiple intestinal perforations, and the patient died from septic shock on postoperative day one.

Sep 29, 2026

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