On 3rd postoperative day the patient developed a gradually increasing swelling under the sutures
on left chest wall without pain or discharge and there was no fever. The swelling is shown in picture below:
He was sent for a chest X ray and it is shown below;
Photograph of the large soft tissue lesion (the first picture), and X-ray chest show that lung fields are clear and a large soft tissue lesion over the chest wall under the suture which developed postoperatively and gradually increased in size without pain or discharge is suggestive of development of seroma.
Case Discussion:
Seroma is a pocket of clear serous fluid that sometimes develops following surgery, blood plasma seep out of ruptured small blood vessels and the dying injured cells resulting in fluid collection. It is different from hematoma which contains blood cells, and from abscess which contains
pus as a result of infection.
Seromas are sometimes seen after mastectomy, abdominal surgery and plastic surgery. It can also result following an injury.
The serous fluid in the seroma is gradually absorbed over a time (often taking many days or weeks); a knot of calcified tissue sometimes remains.
Management: In seroma depending on the volume of collection and duration of leakage, it may take a few weeks to resolve with aspiration of serum with pressure dressing. Conservative management is usually effective. If a serum or leak does not resolve, it may be necessary to place a suction drain into the wound.
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