The retained intrapericardial sponge: value of the lateral chest radiograph

Our objective was to identify reasons for the difficulty in diagnosing retained intrapericardial sponges and to determine ways to improve diagnostic accuracy.

All three intrapericardially retained sponges were in the posterior pericardium, a region not visible to the surgeon. Radiographic detection of the sponges on standard anteroposterior projections is difficult because of exposure factors, other confusing linear markers, and metallic densities such as sternal sutures. However, knowledge of the typical location of a lost sponge and use of lateral radiographic projections may aid in early detection of this rare complication.