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Efficacy, Education, Administration, Informatics

E3202. Foreign Bodies and Retained Surgical Instruments: Identification and Management

Daruwalla V,  Mohandas A,  Raval K,  Critchfield J,  Harvill M. Wayne State University/Detroit Medical Center, Detroit, MI

Address correspondence to V. Daruwalla (vistasp.daruwalla@gmail.com)

Background Information: Foreign bodies and missed surgical instruments are frequently encountered in day-to-day practice and may prove to be detrimental to the patient if missed on imaging studies. Retained surgical instruments and foreign bodies may lead to perforation, septicemia, and vascular injury. These foreign bodies present a diagnostic challenge for a radiologist who should identify, characterize, provide anatomic location, and determine its clinical significance. The purpose of this exhibit is to review the various types of foreign bodies and retained surgical instruments encountered in daily practice and understand the imaging findings on multiple imaging modalities such as plain radiographs, CT, and conventional angiography, and understanding various interventional radiology procedures performed for their removal and management.

Educational Goals/Teaching Points: This exhibit will teach the viewer to recognize different types of foreign bodies on various imaging modalities, including identifying foreign bodies and retained surgical instruments; injuries leading to foreign body insertion; imaging findings of foreign bodies on various imaging modalities; understanding clinical significance of the location of the foreign bodies and imaging findings for their related complications; and imaging findings for uncommon foreign bodies like wire coatings in vasculature. The role of interventional radiology in retrieving these foreign bodies and understanding the various techniques applied along with their complications is presented. This exhibit will create awareness and familiarity in detecting a wide range of foreign bodies and retained surgical instruments. The viewers will benefit from understanding various imaging findings assisting in identifying these foreign bodies and differentiating them from other medical devices.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: We describe the imaging findings of foreign bodies and missing surgical instruments on multiple imaging modalities.

Conclusion: Imaging is of great importance in detecting and managing foreign bodies. Radiologists must be able to identify them quickly and differentiate them from appropriate medical devices. In complicated cases, CT and fluoroscopy are used. It is our job to remain alert to these foreign bodies so that we correctly guide patient care.