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Pectus excavatum with delayed diagnosis of implant tear on MRI apparently causing recurrent postoperative seromas: A
Arti R Iyer1, Daniel K Powell, Robert D Irish
1Department of Radiology, Mount Sinai Beth Israel Medical Center, New York, NY, USA, ariyer@chpnet.org.
Abstract:
Seroma formation is the most common early postoperative complication after pectus excavatum repair, but later seromas are rare. While many seromas eventually resorb or decrease in size after aspiration, our case demonstrates recurrent seroma formation as a late complication of pectus excavatum repair in a patient with an implant tear. Postoperative seromas can result in prolonged chest wall pain, large chest wall masses, and increased mass effect on the heart with potential risk for resultant right ventricular outflow obstruction. This case report illustrates a solid silicone implant tear. Though rare, early recognition may help to decrease the likelihood of recurrent postoperative seromas.
Insights
Late seroma formation after pectus excavatum repair can occur, especially with implant tears. Early recognition of implant complications is crucial for managing recurrent seromas and preventing chest wall issues.
Area of Science:
- Thoracic surgery
- Plastic surgery
- Medical device complications
Background:
- Pectus excavatum repair often involves implants, with seroma formation being a common early complication.
- Late seromas are infrequent after pectus excavatum repair, typically resolving with conservative management.
Observation:
- This case report details a rare instance of recurrent seroma formation as a late complication following pectus excavatum repair.
- The patient presented with a solid silicone implant tear, leading to the persistent seroma development.
Findings:
- The recurrent seroma was directly linked to a tear in the solid silicone implant used during the pectus excavatum repair.
- Implant integrity is a critical factor in preventing late seroma formation post-surgery.
Implications:
- Early identification of implant tears or complications is vital for addressing late seromas effectively.
- Managing recurrent seromas secondary to implant issues may require specific interventions to prevent prolonged pain and cardiac compromise.
