Neurosurgery notes/Radiology/Radiology general/Intentionally retained surgical material

Intentionally retained surgical material

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Radiology general
  • Oxidized regenerated cellulose (Surgicel or Gelfoam)
    • Has radiographic and CT appearance of tightly packed, swirled, or linear gas bubbles without much fluid content
      • Usual appearance of soft tissue density mass surrounding gas collections
      • May be mistaken for abscess, but contains very little fluid and never shows air-fluid level
        • Check operative note or discuss with surgeon: Correlate with surgical placement of oxidized cellulose
      • Presence of hemostatic sponge does not prevent formation of abscess
        • Presence of larger loculated collection of fluid or air-fluid level suggests abscess
    • Ultrasound
      • Echogenic mass with posterior reverberation artifact (indicating gas content) ± surrounding fluid
    • MR: Low signal on T2 due to predominance of gas over fluid
      • Unlike abscesses, which demonstrate high T2 signal