Tuesday, April 25, 2023

Help! Leakage of fluid after surgery

This patient had an abdominal wall surgery for umbilical hernia. 
Two weeks after surgery, she developed discharge of fluid via an opening in the abdominal wall in infra umbilical region. 
Ultrasound imaging was done which revealed:
Ultrasound findings are:

1. An ultrasound imaging was conducted to assess the infra umbilical region in the peritoneal cavity after abdominal surgery.

2. The ultrasound imaging revealed the presence of a small seroma with an external sinus formation in the infra umbilical region.
This is seen as an anechoic collection just deep to the abdominal wall within the peritoneal cavity. 

3. A seroma is a collection of fluid that can occur after surgery and can be caused by the accumulation of lymphatic fluid or blood.

4. The external sinus formation is a tunnel-like structure that extends from the seroma to the skin surface.

5. The ultrasound imaging also showed the presence of a small discharge of fluid through the sinus.

6. The presence of a small seroma with an external sinus formation can be a potential complication of abdominal surgery and may require medical intervention.

Treatment options :
Treatment options for this condition include drainage of the seroma and sinus, antibiotic therapy to prevent infection, and surgical excision of the sinus if necessary.

Follow-up ultrasound imaging may be necessary to monitor the healing of the seroma and sinus and to ensure that there are no further complications.

Cautionary note:
It is important to consult with a healthcare professional if you experience any symptoms such as pain, swelling, or discharge from the surgical site after abdominal surgery.

Differential Diagnoses in this case include:
1. Abscess: An abscess is a collection of pus caused by a bacterial infection. It can also present with an external sinus and discharge of fluid, similar to a seroma.

2. Hematoma: A hematoma is a localized collection of blood outside of blood vessels, which can occur after surgery. It may also appear similar to a seroma on ultrasound imaging.

3. Fistula: A fistula is an abnormal connection between two organs or between an organ and the skin surface. In this case, it could refer to an abnormal connection between the seroma and the skin surface through the sinus.

Prognosis: in such a case depends on the size of the seroma and the presence of any infection. With appropriate treatment, such as drainage and antibiotics, most patients will recover without complications. However, without treatment, there is a risk of infection, which can lead to serious complications. It is important to follow up with a healthcare professional and adhere to their recommended treatment plan.

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Video of this case: seroma, ultrasound video

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