Retained surgical sponges: CT and US appearance.

Area of Science:

• Radiology
• Surgical Pathology

Background:

• Retained surgical items, such as sponges, are a known complication of abdominal surgery.
• Diagnosis can be challenging, often requiring advanced imaging techniques.

Purpose of the Study:

• To describe the computed tomographic (CT) and ultrasonographic (US) imaging characteristics of retained surgical sponges.
• To highlight the importance of considering retained surgical sponges in the differential diagnosis of abdominal masses.

Main Methods:

• Retrospective review of nine patients with retained surgical sponges confirmed at repeat operation.
• Analysis of CT and US imaging findings, including mass density, enhancement patterns, calcification, and gas presence.
• Correlation of imaging findings with operative confirmation.

Main Results:

• CT demonstrated low-density masses (6/9), complex masses (2/9), and a high-density mass (1/9).
• Rim enhancement was noted in 5/8 cases after contrast administration. Calcification and spongiform gas were observed in 4/9 and 1/9 cases, respectively.
• US revealed echogenic areas with acoustic shadowing (3/6), complex masses (1/6), hypoechoic masses (1/6), and cystic masses (1/6).

Conclusions:

• Retained surgical sponges exhibit variable appearances on CT and US.
• Surgical sponge granuloma should be considered in patients with a history of abdominal surgery presenting with an abdominal mass.