title: A rare case of a blood clot masquerading as a retained surgical drain.
abstract: Surgical drains are commonly used in surgery to reduce post-operative fluid collections. Whilst rare, a retained surgical drain may result in clinical complications and distress to the patient. A retained surgical drain is a potentially avoidable event and surgeons should be aware on how to confirm the presence of a retained surgical drain. We report a rare case of a blood clot masquerading as a retained surgical drain in a patient. The patient is a 55-year-old Malay male who presented with left gluteal necrotizing fasciitis. The patient underwent a further 5 debridements with subsequent closure of the wound. Two drains were inserted on closure. Whilst there was no difficulty in removal of the drain, post removal magnetic resonance imaging revealed a tubular structure in the left gluteal region, thought to be a retained drain segment. Intra-operatively, the drain segment seen on magnetic resonance imaging (MRI) was not found and instead, a tubular blood clot of similar caliber and length as measured on the MRI was found residing in the gluteal region. This case highlights the need for confirmation of a retained drain segment before surgical removal. Surgeons should be certain of the presence of a retained surgical drain before advocating for surgical removal. Plain radiography remains a useful modality for visualization of radio-opaque surgical drains.
authors.affiliation: Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.
authors.forename: Sean Wl
authors.initials: SW
authors.lastname: Ho
authors.affiliation: Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.
authors.forename: Ivan Th
authors.initials: IT
authors.lastname: Chua
keywords: Retained surgical drain; blood clot; magnetic resonance imaging (MRI); radiography