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Retained sponge after thoracotomy that mimicked aspergilloma
H Nomori1, H Horio, T Hasegawa
1Department of Surgery, Saiseikai Central Hospital, Tokyo, Japan.
The Annals of Thoracic Surgery
|May 1, 1996
Summary
Retained surgical sponges after thoracotomy can mimic aspergilloma, presenting as mass shadows with crescent air signs. Early diagnosis is crucial for patients with hemoptysis and a history of chest surgery.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Radiology
Background:
- Mass shadows with crescent air signs on imaging often suggest pulmonary aspergilloma.
- Retained surgical sponges are a rare but serious complication following thoracic surgery.
- Patients with a history of pulmonary tuberculosis surgery may present with unusual thoracic pathologies.
Observation:
- A 63-year-old man presented with massive hemoptysis 40 years post-pulmonary tuberculosis surgery.
- Radiology revealed a mass with a crescent air sign, suggestive of aspergilloma.
- Surgical exploration identified a retained surgical sponge with a bronchial fistula.
Findings:
- The crescent air sign was caused by effusion drainage around the retained sponge.
- A bronchial fistula was present in the lower lobe.
- The retained sponge was well-encapsulated between the lung lobes.
Implications:
- Intrathoracic retained surgical sponges should be considered in differential diagnoses.
- This is crucial for patients with mass shadows, crescent air signs, and no Aspergillus infection.
- A history of thoracotomy is a key indicator for considering this diagnosis.