title: Accuracy of diagnosis on CT scan of Surgicel® Fibrillar: results of a prospective blind reading study.
abstract: OBJECTIVE
  Oxidized regenerated cellulose is a hemostatic agent used in surgery to control bleeding. Some case reports have suggested that it could lead to a mistaken diagnosis of abscess on postoperative CT scan. The objective of this study was to evaluate the diagnostic accuracy of CT scan for Surgicel® Fibrillar.
  
  
  METHODS
  We prospectively registered all patients who had Surgicel® Fibrillar left in the operative site during one year. Patients who had a CT scan for medical reasons (e.g. fever, pain, or occlusive syndrome) were evaluated and we compared the radiologists' conclusions with or without information about the use of Surgicel® (two different radiologists, one blinded to the use of Surgicel®).
  
  
  RESULTS
  18 patients who underwent pelvic laparotomy had Surgicel® Fibrillar left in the operative site. On first interpretation, the radiologist's conclusion was an abscess in 11% of cases, hematoma in 28%, collections with hydro-aeric levels in 33%, lymphocele in 6% and no conclusion in 11% of cases. For only 2 patients (11%) was the conclusion Surgicel® Fibrillar. After second interpretation by a radiologist aware of the presence of Surgicel® Fibrillar, Surgicel® Fibrillar was the main conclusion on 15 CT scans (83%).
  
  
  CONCLUSIONS
  Oxidized regenerated cellulose is a differential diagnosis for abscess or collection. The radiologist should be informed about its presence to increase appropriate evaluation of CT scans and avoid inappropriate treatment.
authors.affiliation: Department of Gynecology-Obstetrics, Hôpital Tenon, Paris, France.
authors.forename: Albane
authors.initials: A
authors.lastname: Frati
authors.forename: Isabelle
authors.initials: I
authors.lastname: Thomassin-Naggara
authors.forename: Marc
authors.initials: M
authors.lastname: Bazot
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
authors.forename: Roman
authors.initials: R
authors.lastname: Rouzier
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Chéreau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002483:Cellulose, Oxidized; D003951:Diagnostic Errors; D005260:Female; D013509:Gynecologic Surgical Procedures; D006490:Hemostatics; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D002483:Cellulose, Oxidized; D006490:Hemostatics; C013695:Surgicel
keywords: Abscess; CT scan; Gynecologic surgery; Surgicel(®) Fibrillar