Surgicel packing and an erroneous diagnosis of mediastinitis in a neonate.
Internal accumulation of the topical hemostatic agent Surgicel can mimic fluid collections that might be misdiagnosed as an abscess or a hematoma upon 3 common postoperative imaging methods. Herein, we report the unusual case of a neonate who underwent surgical repair of complex congenital heart conditions and then required early re-exploration, prompted by initial suspicion of mediastinitis on the basis of computed tomographic findings. During reoperation, it was determined that the mass on computed tomography was an accumulation of oxidized Surgicel. We discuss the capabilities and limitations of various imaging methods in the achievement of an accurate differential diagnosis.
Alves Júnior
Lafaiete
L
Division of Thoracic & Cardiovascular Surgery, Department of Surgery & Anatomy, Riberão Preto Faculty of Medicine, University of São Paolo, 14040-900 São Paolo, Brazil.
Vicente
Walter Villela Andrade
WV
Ferreira
César Augusto
CA
Manso
Paulo Henrique
PH
Arantes
Lidiane Ramos
LR
Pinheiro
Karina Simonelly
KS
Luciano
Paula Menezes
PM
Rodrigues
Alfredo José
AJ
Evora
Paulo Roberto Barbosa
PR
D006348:Cardiac Surgical Procedures; D002483:Cellulose, Oxidized / Q000009:adverse effects*; D003951:Diagnostic Errors; D006330:Heart Defects, Congenital / Q000601:surgery*; D006489:Hemostatic Techniques / Q000009:adverse effects*; D006490:Hemostatics / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008480:Mediastinitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D019564:Unnecessary Procedures
D002483:Cellulose, Oxidized; D006490:Hemostatics; C013695:Surgicel