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Case No. 295
2013-02-04~2013-02-28
출제자 : 최진욱
Hit : 485
| Period | 2013-02-04~2013-02-28 |
|---|---|
| Diagnosis | Gossypiboma |
| Clinical information | Hx. 2009년 타병원 치과에서 양악수술 받았고 내원 한 달 전부터 잇몸이 붓는 증상 진단은? |
| Discussion | Gossypiboma - Mass of cotton matrix that is left behind in a body cavity during an operation - Uncommon surgical complication - Some gossypibomas -> exudative -> cause infection or abscess formation in the early stage - Others remain clinically silent for many years - Cotton that does not stimulate any specific biochemical reaction except adhesion and granuloma formation - When retained, they may cause an asymptomatic condition for a long time Imaging findings - US Cystic or solid mass within hyper- and hypoechoic regions Strong PAS due to material itself or calcified regions or air pocket - CT Low-density heterogeneous mass + external high density wall with well enhancement + Spongiform pattern containing air bubbles Thin metallic density in the mass, wall calcification - MRI A soft tissue-density mass + a thick well-defined capsule + a whirling internal Configuration on T2-WI Thick peripheral wall : Low SI with mild to moderate enhancement Internal SI -Most foreign bodies : hypointense on T1-WI, hyperintense on T2-WI -Retained absorbable hemostatic sponges : can be seen as intermediate on T1-WI and high or complex mixed SI on T2-WI |
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Correct Answer
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