Commonly Encountered Foreign Bodies and Devices in the Female Pelvis: MDCT Appearances

Mausner, Elizabeth V.; Yitta, Silaja; Slywotzky, Chrystia M.; Bennett, Genevieve L.

doi:10.2214/ajr.10.5119

Cited by 20 publications

(10 citation statements)

References 15 publications

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“…Most of the case reports describing oxidized cellulose imitating a postsurgical abscess 6–8 and granuloma formation mimicking local tumor recurrence 9–11 have been published in the general and urologic surgery literature. Only 1 recent case report in the gynecologic literature described ORC mimicking a pelvic abscess.…”

Section: Discussionmentioning

confidence: 99%

“…6 Imaging features of ORC that help differentiate it from an abscess include a unifocal collection of gas with a linear or punctate pattern, without an air-fluid level. 8 The unusual pattern of the air collection is likely caused by air trapped within the spaces of the hemostatic gauze material. In comparison, a postoperative abscess typically shows air-fluid levels and scattered air bubbles on CT scan.…”

Section: Discussionmentioning

confidence: 99%

“…In comparison, a postoperative abscess typically shows air-fluid levels and scattered air bubbles on CT scan. 8 Imaging features of either ORC or an abscess are nonspecific and could present a diagnostic dilemma. Magnetic resonance or sonographic imaging has been suggested as an alternative diagnostic modality to differentiate between abscess formation and the presence of retained oxidized cellulose.…”

Section: Discussionmentioning

confidence: 99%

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Oxidized Regenerated Cellulose Resembling Vaginal Cuff Abscess

Tam

Harkins

Dykes

et al. 2014

JSLS

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Introduction:Application of oxidized regenerated cellulose is commonly performed in laparoscopy to achieve hemostasis during surgery. The appearance of an abscess resembles oxidized regenerated cellulose, causing imaging studies to be difficult to interpret.Case Description:We describe the cases of 3 patients who underwent oxidized regenerated cellulose placement during laparoscopic gynecologic surgery. They subsequently presented with signs and symptoms resembling an abscess. Computed tomographic imaging can be challenging to interpret in such cases; radiologic findings can be used to differentiate between the characteristics of oxidized regenerated cellulose and those of abscess formation on the vaginal cuff.Discussion:Oxidized regenerated cellulose has an appearance that often mimics postsurgical abscess formation. There are distinct characteristics that distinguish both findings. It is essential that patients' records accurately describe the presence and location of regenerated oxidized cellulose when placed intraoperatively, and this information must be relayed to the interpreting radiologist to facilitate medical diagnosis and guide clinical management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Oxidized Regenerated Cellulose Resembling Vaginal Cuff Abscess

Tam

Harkins

Dykes

et al. 2014

JSLS

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“…Use of bacteriological cultures, ultrasound examination [7] and X ray and other radiological assessment may be needed in few cases. In some patients with poor compliance or deeply impacted foreign bodies not amenable to diagnosis by other modalities, 3D multiplanar CT [8] scans may be necessary to help clinch the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Bizarre Foreign Objects in the Genital Tract—Our Experience and Review of Literature

Sankhwar¹,

Devyani²,

Pyari³

et al. 2014

OJOG

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Foreign objects in the genital tract are commonly encountered by clinicians in all age groups. Patients may or may not be aware of its presence in the body. Usually presenting as offensive vaginal discharge, rare misplacement of these objects may result in fatal complications. Detailed history and clinical examination are central to diagnosis although imaging modalities may be required in misplaced objects. Proper management can prevent morbidity and mortality resulting from complications. Presented here is a series of three cases where patients presenting with varied complaints were diagnosed with genital foreign bodies and managed.

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“…The key CT differential diagnosis of a postoperative pelvic abscess is presence of oxidised regenerated cellulose (Surgicel®, Ethicon), a gauze-like bioabsorbable haemostatic material which mimics as a mixed gas-fluid collection and requires awareness of surgical details to avoid misinterpretation [ 34 ].…”

Section: Ct Imaging Of Post-hysterectomy Complicationsmentioning

confidence: 99%

Multidetector CT of expected findings and complications after hysterectomy

Tonolini

2018

Insights Imaging

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Indicated to manage a variety of disorders affecting the female genital tract, hysterectomy represents the second most common gynaecological operation after caesarean section. Performed via an open, laparoscopic or vaginal approach, hysterectomy is associated with non-negligible morbidity and occasional mortality. Iatrogenic complications represent a growing concern for gynaecologists and may result in prolonged hospitalisation, need for interventional procedures or repeated surgery, renal impairment and malpractice claims. As a result, radiologists are increasingly requested to investigate patients with suspected complications after hysterectomy. In the vast majority of early postoperative situations, multidetector CT represents the ideal modality to comprehensively visualise the surgically altered pelvic anatomy and to consistently triage the varied spectrum of possible injuries. This pictorial review provides an overview of current indications and surgical techniques, illustrates the expected CT appearances after recent hysterectomy, the clinical and imaging features of specific complications such as lymphoceles, surgical site infections, haemorrhages, urinary tract lesions and fistulas, bowel injury and obstruction. Our aim is to increase radiologists’ familiarity with normal post-hysterectomy findings and with post-surgical complications, which is crucial for an appropriate choice between conservative, interventional and surgical management.Teaching points• Hysterectomy via open, laparoscopic or vaginal route is associated with non-negligible morbidity. • Multiplanar CT imaging optimally visualises the surgically altered pelvic anatomy. • Familiarity with early post-hysterectomy CT and expected findings is warranted. • Complications encompass surgical site infections, haemorrhages, bowel injury and obstruction. • Urological complications include ureteral leakage, bladder injury, urinomas and urinary fistulas.

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Commonly Encountered Foreign Bodies and Devices in the Female Pelvis: MDCT Appearances

Cited by 20 publications

References 15 publications

Oxidized Regenerated Cellulose Resembling Vaginal Cuff Abscess

Oxidized Regenerated Cellulose Resembling Vaginal Cuff Abscess

Bizarre Foreign Objects in the Genital Tract—Our Experience and Review of Literature

Multidetector CT of expected findings and complications after hysterectomy

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