Suture granuloma extending intra-abdominally, detected five months postappendectomy

Suture granulomas are localised inflammatory reactions that develop at the site of retained suture material. They are a rare surgical complication that is sometimes radiologically challenging to diagnose, especially if the intra-abdominal is communicating with the anterior abdominal wall.

The case reported here was a 22-year-old female who presented with right iliac fossa pain 5 months post-appendectomy, which turned out to be due to a suture granuloma. Ultrasonography and CT with and without contrast misdiagnosed the lesion as an abscess or less likely as neoplasm. Conclusive diagnosis was based upon histopathological examination of tissue obtained by biopsy.

When reviewing the images of patients who present with post-operative surgical complications, it is crucial to consider suture granuloma as a distinct possibility. A definitive diagnosis saves the patient from undergoing unnecessary extensive surgeries and improves the patient experience.