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Eur J Cardiothorac Surg 2005;27:707
© 2005 Elsevier Science NL

Images in cardio-thoracic surgery

Pitfall in the computed-tomography-diagnosis of postcardiotomy infection: iodine accumulation after irrigation mimicking retrosternal abscess

Robert Bauernschmitta,*, Stefan Martinoffb, Michael Poernerb, Ruediger Langea

a Clinic for Cardiovascular Surgery, German Heart Center Munich, Lazarettstr. 36, 80636 Munich, Germany
b Institute for Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany

Received 10 November 2004; received in revised form 22 November 2004; accepted 26 November 2004.

* Corresponding author. Tel.: +49 89 1218 4062; fax: +49 89 1218 4093. (E-mail: bauernschmitt{at}dhm.mhn.de).

Key Words: Computed tomography • Mediastinitis • Closed-chest irrigation

A patient, after surgical debridement and closed chest iodine solution irrigation, was reoperated for urgent suspicion of retrosternal abscess displayed by an intravenous contrast enhanced CT-scan. No signs of infection were found during surgery and at microbiological analyses. The abscess-like collection turned out to be local iodine solution accumulation (Fig. 1).



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  		Fig. 1. Contrast enhanced CT-scan following second look surgery displays a retrosternal mass which patterns are consistent with an abscess: high attenuation rim, which circumscribes a low attenuation multilocated collection.

 




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V. P. Argitis, P. Schnyder, and L. K. von Segesser
Editorial comment: Bauernschmitt et al. "Pitfall in the computed-tomography-diagnosis of postcardiotomy infection: iodine accumulation after irrigation mimicking retrosternal abscess"
Eur. J. Cardiothorac. Surg., April 1, 2005; 27(4): 707 - 708.
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