CT of retained surgical sponges (textilomas): pitfalls in detection and evaluation.
OBJECTIVE
Our goal was to demonstrate possible pitfalls in the CT diagnosis of retained surgical sponges (textilomas) and to evaluate the impact of gas bubbles inside a textiloma.


METHODS
Thirteen patients with textilomas were investigated with CT 3 weeks to 8 years after surgery. Twelve of the 13 textilomas were removed within 3 weeks after the first CT examination. Eight samples of surgical sponges were placed in a water bath for 6 months. Serial CT was performed to document the presence and persistence of gas bubbles.


RESULTS
The radiopaque marker inside the textiloma was seen in nine patients but did not lead to the diagnosis in all patients. In seven patients gas bubbles were found inside the textiloma with a typical pattern. None of these patients had an abscess formation. In vitro studies demonstrated gas bubbles in all surgical sponges scanned 1 h afterward. The number of gas bubbles was not significantly reduced after 6 months.


CONCLUSIONS
The variable appearance of retained surgical sponges can lead to diagnostic misinterpretations. If present, typical spongiform pattern with gas bubbles is the most specific sign for the detection of textilomas but does not indicate an abscess formation.
Kopka
L
L
Department of Radiology I, University Hospital of Goettingen, Germany.
Fischer
U
U
Gross
A J
AJ
Funke
M
M
Oestmann
J W
JW
Grabbe
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D005549:Foreign-Body Reaction / Q000000981:diagnostic imaging; D006801:Humans; D066298:In Vitro Techniques; D008875:Middle Aged; D010537:Peritoneum / Q000000981:diagnostic imaging*; D015503:Surgical Sponges / Q000009:adverse effects*; D013909:Thorax; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000295:instrumentation