The following PA and Lateral CXR was obtained the day after an uneventful dual chamber pacemaker implantation placed via left cephalic cutdown.

One can see a radiopaque ribbon near the pacemaker can in both views raising the suspicion of a retained operative sponge.  All skin dressings were removed and repeat CXR was performed.

Repeat PA CXR performed after dressing removed leaving steri-strips in place reveals that wound dressing had inadvertently used a radiopaque lap sponge as part of a pressure dressing. Nice case of “pseudo” sponge in the pocket but certainly caused some initial stress during CXR reading!