therapeutic pelvic

An 18 year old 1 month post partum comes in with vag D/C x1 month which "smells like dead people." She has midline abdominal mild tenderness and is afebrile.

I bring her to the GYN room and as I am about to insert the speculum, I ask her about what looks like a pad and she says there is no pad.

I take it out and see that it is black and oozing. Someone had left a 4x4 in her vagina at the delivery. The rest of her exam was normal.

Once the 4x4 was gone and she was put on antibiotics and GYN saw her, we sent her home with Augmentin and close follow up.