A Large Intraperitoneal Free Body in a 69-Year-Old Indian Man: a Case Study

Abstract

Peritoneal Free Bodies, also known as Peritoneal Loose Bodies (PLBs) are uncommon entities that are usually coincidental findings in operative procedures or routine investigations. Peritoneal Loose Bodies in excess of 5–7 cm (2–3 in.) are exceedingly rare and have been very occasionally reported. It is a general consensus that such bodies result from the torsion, infarction, calcification and sometimes adhesion of the epiploic appendages to structures in the peritoneal cavity. Here, we discuss the case of a 69-year-old Indian man, who presented with vague abdominal discomfort and occasional difficulty in micturition, and upon diagnostic laparoscopy and subsequent laparotomy, a Peritoneal Loose Body of size approximately 7.5 × 7 × 6.5 cm3 was found intra-abdominally. We evaluate here the diagnostic considerations and the probable mode of origin of this body in this presentation. Peritoneal Loose Bodies are usually benign entities, in that most of them are relatively small in size and inconsequential. However, sometimes the larger and much rarer ‘Giant’ Peritoneal Loose Bodies give rise to symptoms, and intervention is required in those cases. It remains the responsibility of the treating surgeon to avoid unnecessary operative procedures, and determine the suitability of each individual patient for the same.