Korean J Radiol.  2016 Aug;17(4):541-544. 10.3348/kjr.2016.17.4.541.

CT Findings of Foreign Body Reaction to a Retained Endoloop Ligature Plastic Tube Mimicking Acute Appendicitis: A Case Report

• Ahn JH
• Kang CH
• Choi SJ
• Park MS
• Jung SM
• Ryu DS
• Shin DR

• KMID: 2455424
• DOI: http://doi.org/10.3348/kjr.2016.17.4.541

Abstract

Many hospitals experience one or more retained surgical instrument events with risk of patient morbidity and medicolegal problems. Identification of retained surgical instrument is important. The radiologists should be familiar with imaging finding of retained surgical instrument. In a 62-year-old female with a retained plastic tube, localized peritoneal infiltration around air-containing tubular structure mimicked acute appendicitis on abdomen computed tomography (CT), one year after laparoscopic cholecystectomy. We reported CT findings of foreign body reaction related to retained Endoloop ligature plastic tube mimicking acute appendicitis.

Keyword

Retained surgical instrument; Foreign body; Peritonitis

MeSH Terms

Abdomen/diagnostic imaging
Acute Disease
Appendicitis/diagnosis/surgery
Diagnostic Errors
Female
Foreign-Body Reaction/*diagnosis/diagnostic imaging
Humans
Laparoscopy
Middle Aged
Peritonitis/*diagnosis/diagnostic imaging/etiology
Plastics/*adverse effects/chemistry
*Tomography, X-Ray Computed
Plastics

Figure

• 

  Fig. 1 62-year-old female presented with right lower quadrant pain one year after laparoscopic cholecystectomy. A-D.Axial CT images show localized omental infiltration around air-containing tubular structure in right lower quadrant of abdomen (arrows). These CT findings may mimic acute appendicitis considering its location and appearance. Operative and pathologic results revealed localized peritonitis related to retained Endoloop ligature plastic tube that was used in laparoscopic cholecystectomy. E. Endoloop ligature plastic tube. Endoloop ligature is surgical instrument to facilitate ligation of pedicles in laparoscopic procedures. Vicryl and polydioxanone Endoloop ligature can be used. It consists of 45 cm long ligature inserted into plastic tube (arrows) (narrow at one end and scored at other). Plastic tube should be removed after suture is formed in ligature with knot. F. Coronal reformation CT image shows bizarre tubular structure with oblique direction (arrows) in upper abdomen. We neglected this finding as unexplained artifact. G, H. Axial CT images were reported as no abnormal finding at examined time. On retrospective review of CT images, there was bizarre tubular structure (arrows) corresponding to one seen on F.

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