Sonographic Appearance of Chromic 2-0 Catgut Sutures in the Parenchyma of a Renal Allograft

Abstract

A renal transplant recipient had a urinary fistula repaired and a double-pigtail ureteral stent left and later surgically removed. At this same time, an open biopsy was performed and closed with chromic 2-0 catgut sutures. A sonogram revealed an artifactual image that was interpreted as a fragmented piece of the stent that was left in the patient. An exploratory surgery performed, however, was unremarkable, and the renal incision was again closed with chromic 2-0 catgut sutures. A repeated sonogram demonstrated the previous artifact, which raised the suspicion that this appearance should be attributed to the chromic 2-0 catgut sutures. An experiment using a model of coupling gel and chromic 2-0 catgut sutures demonstrated artifacts that matched those seen during sonography of this particular renal allograft. This sonographic artifactual appearance may be seen in hypostenic patients with a high-frequency transducer centered over chromic 2-0 catgut sutures.