Basharat Ali Khan, Ali Akbar, Jehanzeb Tariq.
A gauze piece in the urinary bladder.
Fauji Found Health J Jan ;2-1:50-1.

A forty three-year-old male presented with post vesicolithotomy recurrent urinary tract infections. At cystoscopy a gauze piece was ,found in his urinary bladder. It -was removed suprapubically and the patient was cured of his urinary problems. Unwanted foreign bodies anywhere in the human body are poorly tolerated. These are introduced into various parts of the humans by themselves or by others. There have been numerous reported incidents of patients having psychiatric problems or by children introducing common pins into the urethra, torches and bottles etc into the rectum and ingesting hair, papers and other debris forming trichobezoars. Similarly foreign objects may be pushed into the auditory canal and other orifices of the body. During operations surgical team may overlook an instrument or a gauze piece inside the human body. Foreign bodies usually cause severe symptoms until they are removed. Case report: A forty three-year-old male presented with recurrent urinary tract infections. He complained of fever with rigors and severe symptoms of bladder outflow obstruction resulting in - acute urinary retention requiring an indwelling catheter for the last three weeks. Three weeks ago he had an open vesicolithotomy performed by a qualified surgeon at a peripheral private hospital. His postoperative recovery was marred by urinary tract infections not responding to various courses of oral and intravenous antibiotics. At admission in our unit he had daily multiple fever spikes of 103°F with rigors. His white cell count was 12.2x 103 /mm and haemoglobin was 13.6g/dl. Blood urea and serum creatinine were within normal limits. Urine routine examination showed numerous red cells and pus cells. Urine culture did not grow any bacteria since the patient was on antibiotics. An ultrasound scan showed an hyperechoeic 8cm x 5cm shadow within urinary bladder. Patients fever did not respond to oral ciprofloxacin followed by intravenous gentamycin and ceftriaxone for six days. Antibiotics were, therefore, discontinued and an. empirical course of antimalarial, Artimether was started. His fever settled and a cystoscopy was then carried out.

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