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Omental Pseudocyst Following an Open Groin Surgery: A Cause for Concern
Vivek Peddakota1, Manjunath Maruti Pol1, Jagadeep Ajmera1
1General Surgery, All India Institute of Medical Sciences, New Delhi, IND.
Abstract:
Retained, non-absorbable sutures following surgical procedures can lead to rare complications, including pseudocyst formation. Here, we present a unique case of an omental pseudocyst caused by suture migration after an open inguinal hernia repair with mesh. A 31-year-old male with a history of right-sided open mesh hernioplasty performed two years prior presented with dull, aching abdominal pain persisting for six months. Clinical examination was unremarkable except for a right groin scar. Ultrasonography and contrast-enhanced computed tomography (CT) of the abdomen revealed a complex omental cyst and cholelithiasis. The patient underwent laparoscopic excision of the omental cyst and cholecystectomy. The excised cyst contained knotted, non-absorbable sutures and pus-like fluid, confirming the diagnosis of an omental pseudocyst caused by suture migration. This case highlights three key concerns regarding retained non-absorbable sutures: the potential for suture migration, pseudocysts formation, and challenges in diagnosing rare post-operative complications.
Insights
Retained sutures after surgery can migrate and form painful pseudocysts. This case shows a rare omental pseudocyst caused by migrating sutures from a prior hernia repair.
Area of Science:
- Surgical complications
- Gastroenterology
- Medical imaging
Background:
- Non-absorbable sutures can cause delayed complications after surgical procedures.
- Inguinal hernia repair with mesh is a common surgical intervention.
Observation:
- A 31-year-old male presented with chronic abdominal pain six months post-inguinal hernia repair.
- Imaging revealed an omental cyst and gallstones.
- Laparoscopic surgery identified knotted sutures within the excised omental cyst.
Findings:
- The patient was diagnosed with an omental pseudocyst secondary to suture migration.
- The pseudocyst contained purulent fluid and non-absorbable sutures.
- Cholelithiasis was also identified and treated concurrently.
Implications:
- This case underscores the potential for retained sutures to migrate and cause intra-abdominal pseudocysts.
- Delayed diagnosis of such complications can be challenging.
- Awareness of these rare post-operative issues is crucial for clinicians.
