Suture granuloma

Case contributed by Chris O'Donnell
Diagnosis almost certain

Presentation

Laparoscopic cholecystectomy 7 years ago. Now painful red mass in the umbilicus at the site of a laparoscopy port

Patient Data

Age: 60 years
Gender: Male
ultrasound

Small solid mass with subtle increase in blood flow in the umbilicus with central linear echogenic material consistent with a foreign body, e.g. suture material.

CT for depth, rule out hernia

ct

Small soft tissue mass in the umbilicus without deeper extent in the abdominal cavity. Suture material not seen as a dense foreign body.

Case Discussion

These granulomas are a reaction to foreign material and, perhaps surprisingly, can present many years after the surgical procedure. Treatment is by excision of the granuloma and associated foreign body (suture).

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