{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T21:35:56Z","timestamp":1769636156641,"version":"3.49.0"},"reference-count":16,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Absorbable haemostatic agents such as Surgicel\u00ae Fibrillar are useful adjuncts to control post-surgical bleeding in cardiac surgery. The material is purposefully left in situ and it slowly degrades over time. Previous publications, mainly in general and gynaecological surgery, have demonstrated that these materials can mimic gangrenous infection, abscesses, anastomotic leak, and early tumour recurrence in imaging studies. These findings can often lead to unnecessary re-interventions or re-operations. The number of reports in the cardiothoracic surgical field is limited. Case Presentation: We report a 45-year-old man who underwent aortic valve replacement and ascending aorta and hemiarch replacement. In this case, Surgicel\u00ae Fibrillar was used to optimise graft contouring, contributing to postoperative imaging appearances that initially raised concern for infection. The patient was conservatively managed given his stable clinical picture and focused review of CT images with the knowledge of location of Surgicel\u00ae Fibrillar. Repeat CT scan after 2 weeks showed a significant reduction in collection size and complete resolution of air bubbles within the collection. Conclusions: It is important for cardiothoracic surgeons and radiologists to be aware of the early CT appearances of haemostatic agents to minimise erroneous diagnosis of postoperative complications leading to unnecessary interventions. This case highlights a diagnostic pitfall in postoperative imaging, where retained absorbable haemostatic material may mimic serious infective complications and lead to unnecessary re-intervention if operative and radiological findings are not carefully correlated.<\/jats:p>","DOI":"10.3390\/reports9010040","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T08:48:04Z","timestamp":1769590084000},"page":"40","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Non-Woven Haemostatic Agent Mimicking Perigraft Abscess Following Thoracic Aortic Surgery"],"prefix":"10.3390","volume":"9","author":[{"given":"Ali","family":"Ansaripour","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Oxford Heart Centre, John Radcliffe Hospital, Oxford, OX3 9DU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arian Arjomandi","family":"Rad","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Oxford Heart Centre, John Radcliffe Hospital, Oxford, OX3 9DU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"D\u2019Alessio","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Oxford Heart Centre, John Radcliffe Hospital, Oxford, OX3 9DU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonios","family":"Kourliouros","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Oxford Heart Centre, John Radcliffe Hospital, Oxford, OX3 9DU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"275","DOI":"10.2214\/ajr.160.2.8424333","article-title":"Appearance of oxidized cellulose (Surgicel) on postoperative CT scans: Similarity to postoperative abscess","volume":"160","author":"Young","year":"1993","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_2","first-page":"20210031","article-title":"Multimodality imaging of Surgicel\u00ae, an important mimic of post-operative complication in the thorax","volume":"3","author":"Roshkovan","year":"2021","journal-title":"BJR Open"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1093\/ehjci\/jet126","article-title":"Misdiagnosis by transoesophageal echo of post-operative cardiac thrombus and tamponade due to Surgicel\u00ae Fibrillar","volume":"15","author":"Plotkin","year":"2014","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1517\/14712598.2013.848193","article-title":"Comparison of hemostatic agents used in vascular surgery","volume":"13","author":"Vyas","year":"2013","journal-title":"Expert Opin. Biol. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.ejogrb.2013.04.008","article-title":"Accuracy of diagnosis on CT scan of Surgicel\u00ae Fibrillar: Results of a prospective blind reading study","volume":"169","author":"Frati","year":"2013","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"275","DOI":"10.7863\/ultra.15.08014","article-title":"Delayed absorption of oxidized cellulose (Surgicel) in post-thyroidectomy patients","volume":"35","author":"Liu","year":"2016","journal-title":"J. Ultrasound Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.radcr.2015.08.002","article-title":"Intraovarian oxidized cellulose (Surgicel) mimicking acute ovarian pathology after recent pelvic surgery","volume":"10","author":"Zhang","year":"2015","journal-title":"Radiol. Case Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S115","DOI":"10.1097\/01.PAT.0000461660.24340.8e","article-title":"Oxidised cellulose (Surgicel) granuloma radiologically mimicking recurrent renal cell carcinoma: An example of iatrogenic pathology demonstrable by histochemical staining","volume":"47","author":"Sharifi","year":"2015","journal-title":"Pathology"},{"key":"ref_9","first-page":"e46587","article-title":"Surgicel\u00ae granuloma mimicking recurrent thyroid tumor after thyroidectomy: A case report and literature review","volume":"15","author":"Alameer","year":"2023","journal-title":"Cureus"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1177\/1742271X20911411","article-title":"Ultrasound appearance of SURGICEL\u00ae absorbable hemostat (oxidised cellulose) following laparoscopic resection of a splenic cyst\u2014A potential diagnostic peril","volume":"28","author":"Jenkins","year":"2020","journal-title":"Ultrasound"},{"key":"ref_11","first-page":"481","article-title":"Use of oxidized regenerated cellulose as a hemostatic agent in neurosurgery: Appraisals and recommendations to prevent postoperative complications and facilitate follow-up","volume":"38","author":"Franceschini","year":"2021","journal-title":"Surg. Technol. Int."},{"key":"ref_12","first-page":"22","article-title":"Postoperative Surgicel mimicking pelvic abscess causing mechanical bowel obstruction following abdominal hysterectomy","volume":"2","author":"Mathew","year":"2018","journal-title":"Ann. Gynecol. Obstet."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.carbpol.2019.04.036","article-title":"Internal surgical use of biodegradable carbohydrate polymers. Warning for a conscious and proper use of oxidized regenerated cellulose","volume":"216","author":"Franceschini","year":"2019","journal-title":"Carbohydr. Polym."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ehjcr\/ytaa334","article-title":"Surgicel mimicking early-onset prosthetic valve endocarditis: Case report","volume":"4","author":"Regragui","year":"2020","journal-title":"Eur. Heart J. Case Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1093\/icvts\/ivy006","article-title":"Surgicel\u00ae packing remnants mimicking mediastinitis after adult cardiac surgery","volume":"26","author":"Kaneyuki","year":"2018","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e317","DOI":"10.1016\/j.athoracsur.2021.02.046","article-title":"Surgicel-related uptake on positron emission tomography scan mimicking prosthetic valve endocarditis","volume":"112","author":"Pubul","year":"2021","journal-title":"Ann. Thorac. Surg."}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/1\/40\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T09:16:50Z","timestamp":1769591810000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/1\/40"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["reports9010040"],"URL":"https:\/\/doi.org\/10.3390\/reports9010040","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]}}}