Surgicel® mimicking a retained appendix on CT: a case report and literature review of diagnostic pitfalls in retained Surgicel® cases

Cross-sectional imaging, particularly computed tomography, is vital in post-operative care but can pose diagnostic challenges. Absorbable hemostatic agents like Surgicel® may mimic abscesses or hematomas, leading to misinterpretation. This review explores these pitfalls and presents a relevant case. 10 studies, including case reports, series, and observational studies, were reviewed to identify imaging characteristics and misdiagnoses of retained Surgicel® across cardiac, neurosurgical, abdominal, and gynecological surgeries. Surgicel® often appears as low-attenuation or gas-containing masses, mimicking complications like abscesses. Misdiagnoses frequently led to unnecessary imaging, treatments, or reoperations. Contributing factors included limited awareness of Surgicel®'s imaging appearance and potential for contrast enhancement. Misinterpretation of Surgicel® can increase interventions and healthcare costs. Clear communication between surgeons and radiologists about its use and location, along with radiologist awareness and clinical correlation, is key to avoiding misdiagnosis and improving patient care.