Imaging of thoracic textiloma.
OBJECTIVE
Intrathoracic textiloma or gossypiboma, a retained surgical sponge in the thoracic cavity, is an exceptional but serious complication following thoracic or abdominal surgery. The purpose of this work is to highlight the topographic features of thoracic textiloma and to describe imaging aspects, and, particularly, computed tomography (CT) features.


METHODS
Eight patients have been operated in our thoracic surgery department for thoracic gossypiboma. In the past, three patients had undergone hepatic surgery and the five others had a history of thoracic surgery. All the patients had a chest radiograph, five of them had a thoracic ultrasonography, all had a chest CT, and one patient had a chest magnetic resonance imaging (MRI).


RESULTS
In patients with a history of abdominal surgery, the foreign body was located in the parenchyma of the right lower lobe. In the other patients, the foreign body was either intrapleural or mediastinal. Ultrasonography suggested the diagnosis of textiloma in three of the five patients by demonstrating a non-calcified hyperechoic mass with acoustic shadow. At CT, the gossypiboma was a low-attenuating mass containing trapped gas lucencies in six patients and it was a high-attenuating mass in two patients. MRI showed a diaphragmatic defect in one patient with an intrapulmonary gossypiboma that migrated from the abdomen.


CONCLUSIONS
The CT aspect of thoracic gossypiboma may be different according to pleural or parenchymal location. The spongiform appearance, characteristic in abdominal gossypiboma, is not the only CT presentation of thoracic gossypiboma. The confrontation of the surgical history with the CT signs helps to have a preoperative diagnosis.
Department of Radiology, Abderrahmane Mami Hospital, 2080 Ariana, Tunisia. imene.ridenebenrejeb@rns.tn
Imene
I
Ridene
Saoussen
S
Hantous-Zannad
Asma
A
Zidi
Belhassen
B
Smati
Ines
I
Baccouche
Tarek
T
Kilani
Khaoula
K
Ben Miled-M'rad
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D015503:Surgical Sponges; D019616:Thoracic Surgical Procedures / Q000009:adverse effects; D013909:Thorax; D014057:Tomography, X-Ray Computed / Q000379:methods