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Distinguishing Gelatin Bioabsorbable Sponge and Postoperative Abdominal Abscess on CT

Kumaresan Sandrasegaran1, Chandana Lall1, Arumugam Rajesh2 and Dean T. Maglinte1

1 Department of Radiology, Indiana University School of Medicine, 550 N University Blvd., Indianapolis, IN 46202.
2 Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, United Kingdom LE5 4PW.



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  		Fig. 1A. —CT images show gelatin bioabsorbable sponge. Axial CT images of 45-year-old woman who had cystectomy and creation of Hartmann's pouch show lower pelvis. These images, which were obtained using soft-tissue (A) and lung (B) window settings, show gas-filled structure with stripelike configuration (arrow), which is consistent with gelatin bioabsorbable sponge.

 


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  		Fig. 1B. —CT images show gelatin bioabsorbable sponge. Axial CT images of 45-year-old woman who had cystectomy and creation of Hartmann's pouch show lower pelvis. These images, which were obtained using soft-tissue (A) and lung (B) window settings, show gas-filled structure with stripelike configuration (arrow), which is consistent with gelatin bioabsorbable sponge.

 


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  		Fig. 1C. —CT images show gelatin bioabsorbable sponge. Axial CT image of mid abdomen of 55-year-old man after undergoing orthotopic liver transplantation shows typical linear stripelike appearance of gelatin bioabsorbable sponge (straight arrow). High-attenuation fluid collection (curved arrow) surrounds sponge. Patient did not have clinical or laboratory evidence of infection. Appearances are suggestive of intraoperative hematoma.

 


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  		Fig. 2A. —51-year-old man who underwent partial right nephrectomy for renal carcinoma. CT images obtained using soft-tissue (A) and lung (B) window settings show rounded gas pockets in gelatin bioabsorbable sponge (arrow). Note that Gelfoam (Pharmacia) has Hounsfield density between that of fat and air.

 


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  		Fig. 2B. —51-year-old man who underwent partial right nephrectomy for renal carcinoma. CT images obtained using soft-tissue (A) and lung (B) window settings show rounded gas pockets in gelatin bioabsorbable sponge (arrow). Note that Gelfoam (Pharmacia) has Hounsfield density between that of fat and air.

 


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  		Fig. 3. —47-year-old woman who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy for infarcted myoma. CT image depicts fluid collection with enhancing rim (curved arrow), which is suggestive of abscess. Patient had fever, and purulent material subsequently was aspirated from collection. On anterior aspect of abscess is a gelatin bioabsorbable sponge (straight arrow). Unlike gas bubbles in abscess, which are discrete and rounded (arrowhead), gas pockets within gelatin bioabsorbable sponge are tightly packed.

 


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  		Fig. 4A. —45-year-old woman who underwent cystectomy. Axial CT images of lower pelvis obtained on postoperative days 5 (A), 15 (B), and 26 (C) show gradual resorption of gelatin bioabsorbable sponge (arrow).

 


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  		Fig. 4B. —45-year-old woman who underwent cystectomy. Axial CT images of lower pelvis obtained on postoperative days 5 (A), 15 (B), and 26 (C) show gradual resorption of gelatin bioabsorbable sponge (arrow).

 


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  		Fig. 4C. —45-year-old woman who underwent cystectomy. Axial CT images of lower pelvis obtained on postoperative days 5 (A), 15 (B), and 26 (C) show gradual resorption of gelatin bioabsorbable sponge (arrow).

 


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  		Fig. 5A. —52-year-old man who underwent partial left nephrectomy. Serial CT scans show reabsorption of gelatin bioabsorbable sponge (arrows). Despite resorption, tightly packed gas configuration is maintained without bubbles dispersing.

 


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  		Fig. 5B. —52-year-old man who underwent partial left nephrectomy. Serial CT scans show reabsorption of gelatin bioabsorbable sponge (arrows). Despite resorption, tightly packed gas configuration is maintained without bubbles dispersing.

 

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