CTICasesRecurrent Mediastinal Seroma Post Aortic Repair
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Imaging findings
Initial post-operative radiographs and CT were unremarkable after aortic repair. Months later, the patient presented with a large, non-contrast-enhancing mediastinal fluid collection, posterior to the sternum, that increased in size over time. The fluid, described as yellow, clear, serum-looking with minimal cellularity, recurred quickly after drainage, which was initially bloody but not actively so.
Key takeaways
This is a puzzling case of recurrent mediastinal seroma following aortic repair. Differential considerations include a slow leak from the repair site or a reaction to retained surgical materials like Gelfoam, which can become osmotically active as it dissolves, drawing in fluid. Lymphangiogram was negative for chylous leak. This highlights a rare and challenging post-surgical complication.
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