Retained drain fragments detected by FDG-PET/CT: Horroroma of surgery

A. Ayan , F. S. Kıraç,

Abstract: Background. Retained surgical items frequently including surgical textiles and miscellaneous items are common types of malpractice, which may cause different complications and be subjects of medicolegal lawsuits. We describe two cases of retained plastic surgical drain fragments in previous surgery and their possible consequences. Case Reports. We present a fifty two years old female with breast cancer presented with pain in the left hemitorax over the mastectomy area a year after mastectomy and a fifty eight years old male with tongue root tumor who had a history of bilateral radical cervical dissection treated for Pseudomonas infection short after the surgery complaining firm swelling in the left site of neck. They both underwent 18F-FDG-PET/CT scan to detect possible recurrent or metastatic disease. 18F-FDG-PET/CT images demonstrated increased FDG accumulation in some degree, in the previous operation sites, whereas non-diagnostic CT images showed hyperdense linear structures, which were segments of fragmented plastic surgical drains. Conclusion. In this manuscript we named retained surgical drains and their fragments as “Horroromas” which are still nameless, expressing the fear in patients and health care providers. Incidence of retained surgical items, both gossypibomas and horroromas are known to be higher than reported because of the fear of litigations and lawsuits
Keywords: Retained Surgical Items, Drains, 18F-FDG-PET/CT, malpractice