CTと超音波の所見に顕著な乖離を認めた癒着防止剤併用婦人科手術後の6例

Six cases of post-gynecological surgery with adhesion prevention agents showing notable discrepancies between CT and ultrasound findings

セプラフィルム^®（以下，SF）は腹骨盤部の外科手術時に使用される癒着防止剤の一つである。SFは術後癒着形成の減少に有効であることが示されているが，術後感染症や異物反応などの合併症と関連することが知られている^1）。今回我々は，SFを使用した婦人科手術後に液体貯留を認めた場合，その画像的特徴はどのようなものか，どのように画像診断すべきか，という点に留意し，造影CTと経腟超音波検査を中心に，検討を行った。

This paper examines the clinical and imaging characteristics of fluid accumulation observed in six gynecological postoperative cases using Seprafilm^®, an anti-adhesion agent. Initially, these cases were suspected as hematomas in gynecology, but hematomas were ruled out based on CT values, and there were inconsistencies with the diagnosis of abscesses as well. Test punctures performed in two cases yielded serosanguineous ascites-like fluid, with no bacteria detected in culture. While sterile fluid accumulation following the use of Seprafilm^® is a well-known condition, there are no reports summarizing its imaging characteristics. The results of this study showed that contrast-enhanced CT revealed unilocular cysts, while transvaginal ultrasound examination showed multilocular cysts, presenting imaging characteristics distinct from the usual abscesses encountered.