Case Reports

Silent Intruders: Recurrent Suture Granuloma Unveiled in Caesarean Scar

Abstract

Objective: To describe the clinical and radio-pathological features of suture granuloma, an inflammatory response to retained suture material that primarily affects non-absorbable sutures.
Case report: We report a case of a 26-year-old female presenting with painful swelling at a caesarean section scar, previously excised for similar complaints. Physical examination revealed a solid soft tissue mass on the scar. Magnetic resonance imaging (MRI) identified a 2x2 cm lesion in the right abdominal wall, suggestive of suture granuloma. Surgical excision revealed prolene suture material within the granulomatous tissue. Histopathology confirmed foreign body reaction.
Conclusion: Recurrence post-prior excision underscores the importance of complete granuloma removal. Differential diagnoses included scar endometriosis and inflammatory lesions. Suture granulomas, though rare, require consideration in scar-related swelling. Collaboration between specialties ensures accurate diagnosis and management.

1. Augustin G, Korolija D, Skegro M, Jakic-Razumovic J. Suture granuloma of the abdominal wall with intra-abdominal extension 12 years after open appendectomy. World J Gastroenterol. 2009;15(32):4083-6.
2. Postlethwait RW, Willigan DA, Ulin AW. Human tissue reaction to sutures. Ann Surg. 1975;181(2):144-50.
3. Chen L, Penne RB. Complications Associated with Polydek Sutures Used in Eyelid Lateral Tarsal Strip Procedures. Clin Med Res. 2022;20(2):107-110.
4. Takeshita N, Tohma T, Miyauchi H, Suzuki K, Nishimori T, Ohira G, et al. Suture Granuloma with False-Positive Findings on FDG-PET/CT Resected via Laparoscopic Surgery. Int Surg. 2015;100(4):604-7.
5. Secil M, Mungan U, Yorukoglu K. Suture granuloma after orchiectomy: sonography, doppler and elastography features. Int Braz J Urol. 2015;41(4):813-6.
6. Joyce S, Rao Sripathi BH, Mampilly MO, Firdoose Nyer CS. Foreign body granuloma. J Maxillofac Oral Surg. 2014;13(3):351-4.
7. Eladawi S, Ragab A, Kayed M, Elsabaa B, Khaled M. Suture granuloma extending intra-abdominally, detected five months postappendectomy. BJR Case Rep. 2021;7(5):20200191.
8. Hodgson NC, Malthaner RA, Ostbye T. The search for an ideal method of abdominal fascial closure: A meta-analysis. Ann Surg. 2000;231(3):436-42.
Files
IssueVol 18, No 3 (September 2024) QRcode
SectionCase Reports
DOI https://doi.org/10.18502/jfrh.v18i3.16662
Keywords
Silent Intruders Recurrence Granuloma Caesarean Scar
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Sanap A, Yadav A, Choudhary A, Kamath A, Bhimgade P, Patokar G, Moharana B. Silent Intruders: Recurrent Suture Granuloma Unveiled in Caesarean Scar. J Family Reprod Health. 2024;18(3):197-199.