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Metallic staples line mimicking a retained surgical sponge
L Cardinale1, C Fava, N Dervisci
1University of Turin, Department of Clinical & Biological Sciences, Radiology Unit, San Luigi Hospital, 1-10043 Orbassano (Torino), Italy. luciano.cardinale@gmail.com
Summary
A retained surgical sponge can mimic a tumor on CT scans after lung surgery. Surgeons and radiologists must differentiate between actual retained sponges and post-operative changes to avoid misdiagnosis.
Area of Science:
- Thoracic Surgery
- Surgical Pathology
- Radiology
Background:
- Retained surgical sponges are a known complication of surgical procedures.
- Accurate diagnosis of retained surgical sponges is crucial for patient safety and outcomes.
Observation:
- A patient with myotonic dystrophy type 1 underwent a right upper lobectomy for neuroendocrine carcinoma.
- Postoperative CT scan revealed a complex mass with a radiopaque thread, initially suspected to be a retained sponge.
- Surgical exploration identified hemorrhagic infarction, not a foreign body.
Findings:
- The "retained sponge" on CT was actually a false positive finding.
- Post-operative changes, specifically hemorrhagic infarction, can mimic retained surgical sponges.
- Mechanical staples used during the procedure may contribute to the confusing imaging appearance.
Implications:
- Thoracic surgeons and radiologists must consider post-operative changes as a differential diagnosis for suspected retained sponges.
- Awareness of this imaging pitfall can prevent unnecessary interventions and improve diagnostic accuracy.
- This case highlights the importance of careful interpretation of imaging in the post-operative setting.
