CT OF RETAINED SURGICAL SPONGES (TEXTILOMAS) - PITFALLS IN DETECTION AND EVALUATION

Purpose: Our goal was to demonstrate possible pitfalls in the CT diagn osis of retained surgical sponges (textilomas) and to evaluate the imp act of gas bubbles inside a textiloma. Method: Thirteen patients with textilomas were investigated with CT 3 weeks to 8 years after surgery. Twelve of the 13 textilomas were removed within 3 weeks after the fir st CT examination. Eight samples of surgical sponges were placed in a water bath for 6 months. Serial CT was performed to document the prese nce and persistence of gas bubbles. Results: The radiopaque marker ins ide the textiloma was seen in nine patients but did not lead to the di agnosis in all patients. In seven patients gas bubbles were found insi de the textiloma with a typical pattern. None of these patients had an abscess formation. In vitro studies demonstrated gas bubbles in all s urgical sponges scanned 1 h afterward. The number of gas bubbles was n ot significantly reduced after 6 months. Conclusion: The variable appe arance of retained surgical sponges can lead to diagnostic misinterpre tations. If present, the typical spongiform pattern with gas bubbles i s the most specific sign for the detection of textilomas but does not indicate an abscess formation.