An Unusual Cause of Chronic Lumbar Back Pain: Retained Surgical Gauze Discovered after 40 Years

An Unusual Cause of Chronic Lumbar Back Pain: Retained Surgical Gauze Discovered after 40 Years - Rajkovi? - 2010 - Pain Medicine - Wiley Online LibrarySkip to Main Content

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PUBLICATIONSBROWSE BY SUBJECTRESOURCESABOUT US LOGIN Enter e-mail address Enter password REMEMBER ME NOT REGISTERED ?FORGOTTEN PASSWORD ?INSTITUTIONAL LOGIN > JOURNAL TOOLS Get New Content Alerts Get RSS feed Save to My Profile Get Sample Copy JOURNAL MENU Journal Home FIND ISSUES Current IssueAll IssuesVirtual Issues FIND ARTICLES Early View GET ACCESS Subscribe / Renew FOR CONTRIBUTORS Author GuidelinesSubmit an Article ABOUT THIS JOURNAL Society InformationNewsOverviewEditorial BoardPermissionsAdvertiseContact SPECIAL FEATURES Professional OpportunitiesPainPoints Blog An Unusual Cause of Chronic Lumbar Back Pain: Retained Surgical Gauze Discovered after 40 YearsZoran Rajkovi? MD1,*, Silvio Altarac MD, PhD2, Dino Pape? MD1Article first published online: 28 OCT 2010

DOI: 10.1111/j.1526-4637.2010.00969.x

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How to CiteRajkovi?, Z., Altarac, S. and Pape?, D. , An Unusual Cause of Chronic Lumbar Back Pain: Retained Surgical Gauze Discovered after 40 Years. Pain Medicine, no. doi: 10.1111/j.1526-4637.2010.00969.x

Author Information1

Departments of Surgery

2

Urology, Zabok General Hospital, Zabok, Croatia

*Correspondence: Zoran Rajkovi? MD,

*Correspondence: Zoran Rajkovi?, MD, Institutional address: Zabok General Hospital, Bra?ak 8,?49210?Zabok, Croatia, Home address: Bene?i?eva 7,?10000?Zagreb, Croatia. Tel: +385?98?719260; Fax: +385?1?6145400; E?mail: zrajkovi@gmail.com.

Publication HistoryArticle first published online: 28 OCT 2010 SEARCH Search Scope All contentPublication titlesIn this journalIn this issue Search String Advanced >Saved Searches > SEARCH BY CITATION Volume: Issue: Page: ARTICLE TOOLSGet PDF (298K)Save to My ProfileE-mail Link to this ArticleExport Citation for this ArticleRequest Permissions AbstractArticleReferencesCited By View Full Article (HTML) Get PDF (298K) Keywords:Retained Gauze;Textilloma;Gossypiboma;Lumbar Back;Chronic PainAbstract

Objective.? Retained surgical gauze left inside the patient during a surgical procedure is called textiloma or gossypiboma. Most often found in abdominal and pelvic cavities, retained gauze can cause a variety of symptoms, including fever, palpable mass and pain. Symptoms depend on the location (and possible migration) of the retained gauze and local tissue reaction (inflammatory or aseptic).

Design.? Case report.

Setting and Patients.? We present a case of a patient with lumbar pain and constipation caused by surgical gauze mimicking a tumor, which was retained from previous abdominal surgery performed almost 40 years prior.

Measures.? We discuss the diagnosis, treatment and prevention of retained surgical gauze.

Conclusion.? Retained surgical gauze occurrences are not as rare as they are widely considered to be, and clinicians should be aware of that. In reality, retained gauze can be extremely difficult to diagnose, especially if a patient presents after a very long asymptomatic period.

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Forecasting the need for medical specialists in Spain: application of a system dynamics model

Methodology Patricia Barber and Beatriz Gonzalez Lopez-Valcarcel

Human Resources for Health 2010, 8:24doi:10.1186/1478-4491-8-24

Spain has gone from a surplus to a shortage of medical doctors in very few years. Medium and long-term planning for health professionals has become a high priority for health authorities.

We created a supply and demand-need simulation model for 43 medical specialties using system dynamics. The model includes demographic, education and labour market variables. Several scenarios were defined. Variables controllable by health planners can be set as parameters to simulate different scenarios. The model calculates the supply and the deficit or surplus. Experts set the ratio of specialists needed per 1000 inhabitants with a Delphi method.

In the scenario of the baseline model with moderate population growth, the deficit of medical specialists will grow from 2% at present (2800 specialists) to 14.3% in 2025 (almost 21 000). The specialties with the greatest medium-term shortages are Anesthesiology, Orthopedic and Traumatic Surgery, Pediatric Surgery, Plastic Aesthetic and Reparatory Surgery, Family and Community Medicine, Pediatrics, Radiology, and Urology.

The model suggests the need to increase the number of students admitted to medical school. Training itineraries should be redesigned to facilitate mobility among specialties. In the meantime, the need to make more flexible the supply in the short term is being filled by the immigration of physicians from new members of the European Union and from Latin America.

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