Surgical hemostatic material at liver resection site

Case contributed by Dr Vikas Shah


Major surgery for metastatic neuroendocrine tumour 7 days earlier: distal pancreatectomy, splenectomy and segmental hepatectomy. Spiking temperatures. Drains removed 1 day earlier.

Patient Data

Age: 60 years
Gender: Male

Small volume of free fluid at pancreatic and splenic surgical sites. At the liver resection site, there is a contained "collection" with mixed density fluid, and small bubbles of gas lined up along serpiginous linear low density structures. Bibasal atelectasis.

Case Discussion

The surgeon used "Fibrillar" surgical absorbable hemostatic sponge at the liver resection site. The imaging shows this material as low-density serpiginous strands within the mixed density fluid (likely mix of free fluid, bile and blood), with air bubbles distributed along the line of the material. Correlation with the surgical notes is imperative to avoid over-calling these abscesses. However, low-grade infection within this region cannot be determined by CT alone.

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Case information

rID: 61052
Published: 15th Jun 2018
Last edited: 30th Sep 2018
Inclusion in quiz mode: Included

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