Laparotomy sponges (lap pads) typically have an attached radiopaque strip (seen above) to aid in radiographic detection. However, retained sponges can be missed due to a number of factors: Poor image quality, inadequate field of view, distracting radiopaque operative densities, and inadequate history.
A subtle secondary sign of a retained sponge is mottled radiolucencies representing trapped air. When in doubt, cross sectional imaging can be helpful.
References
- Kaiser CW, Friedman S, Spurling KP, Slowick T, Kaiser HA. The retained surgical sponge. Ann Surg. 1996 Jul;224(1):79-84.
- O'Connor AR, Coakley FV, Meng MV, Eberhardt SC. Imaging of retained surgical sponges in the abdomen and pelvis. AJR Am J Roentgenol. 2003 Feb;180(2):481-9.
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