Abstract
Imaging within 24 to 48 hours after most neurosurgical procedures is a routine practice. Nonresorbable surgical sponges have radiopaque filaments readily visible on CT scans and plain film radiographs. However, the proton-poor barium sulfate responsible for this radio-opacity is generally not detectable on MR imaging in the immediate post-operative period. Findings on MR imaging become more evident with elapsing time and when a foreign-body reaction to the sponge manifests as a mass lesion, which can mimic residual or recurrent intracranial tumor or abscess. Although preventive measures by our surgical colleagues to ensure accurate and correct sponge counts before and after wound closure is paramount, even the most fastidious efforts may rarely result in an inadvertently retained surgical sponge. The role of the radiologist is to recognize the imaging findings of this entity and its potential complications so that appropriate and prompt management can be initiated.
Highlights
It is important that the radiologist be aware of this entity; its imaging appearance; and its potential complications, which include the formation of granulomas and abscesses
Routine postoperative head CT scan performed within 12 hours of surgery showed a serpentine hyperattenuated object in the surgical bed suspicious for a retained surgical sponge (Fig 1)
The term is derived from the Latin word gossypium, meaning “cotton” and the Swahili term boma, meaning “place of concealment” and historically has been used, along with the term textiloma, to describe the foreign-body granulomatous reactions that occur in response to inadvertently retained surgical sponges
Summary
Retained Surgical Sponges after Craniotomies: Imaging Appearances and Complications. The role of the radiologist is to recognize the imaging findings of this entity and its potential complications so that appropriate and prompt management can be initiated. It is important that the radiologist be aware of this entity; its imaging appearance; and its potential complications, which include the formation of granulomas and abscesses. These complications may be mistaken for residual or recurrent neoplasms. We discuss the imaging appearance of retained surgical sponges after neurosurgical procedures in 3 patients and review the potential complications should these go unidentified
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