Gossypiboma - inguinal region

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Painful swelling of the right inguinal region 10 days following surgery for an inguinal hernia.

Patient Data

Age: 40 years
Gender: Male
ultrasound

Collection in the right inguinal region containing an arciform echogenic structure with intense posterior acoustic shadowing.

Both testes are normal in size and echotexture.

Right inguinoscrotal collection with thick enhanced wall and mixed content (air and fluid) as well as a well-defined ovoid structure with air-bubbles within and fat stranding of the surrounding subcutaneous fatty tissue and adjacent pelvic region.

Left inguinal hernia medial to the epigastric vessels, containing omental fat (direct inguinal hernia)

The rest of the CT scan exam was unremarkable.

Case Discussion

The ultrasound and CT features in a patient with a history of surgery are highly suggestive of a gossypiboma which was confirmed at surgery (a surgical gauze was removed).

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