Preventing retained foreign objects in ob/gyn surgery

A 44-year-old woman underwent an uneventful abdominal supracervical hysterectomy. Sponge and needle counts were reported as correct on multiple occasions during surgery. On postoperative day 2, the patients reported abdominal pain and mild abdominal distention. Despite conservative measures taken, the pain and distention did not resolve. On postoperative day 4, she was vomiting and her abdomen appeared further distended. An X-ray revealed an intra-abdominal laparatomy pad and small bowel obstruction.