Presentation
Right abdominal pain. History of laparoscopic cholecystectomy.
Patient Data
The CT scan demonstrates:
small hypodense fluid collection with peripheral enhancement and surrounding fat stranding of subhepatic/paracolic location in contact with the colonic wall which shows a reactive thickening with a blind fistulous tract towards the transversus abdominis muscle
another small similar hypodense abdominal fluid collection of left paramedian location centered on the greater omentum in contact with the rectus abdominal muscle with surrounding fat stranding
right ovarian unilocular cyst with homogeneous fluid content (6 x 4 cm) suggestive of serous inclusion cyst
The ultrasound images show two ill-defined hypoechoic collections of right paracolic and left paramedian location, each one contains an arciform echogenic structure with intense posterior acoustic shadowing highly suggestive of gossypibomas.
Case Discussion
The CT and ultrasound features in a patient with a history of surgery are highly suggestive of gossypibomas, that were confirmed at surgery (infected surgical gauzes).
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