Peritoneal Loose Bodies Research Articles

Rectal endoscopic full-thickness resection of peritoneal loose body.

Rectal endoscopic full-thickness resection of peritoneal loose body.

A rare case of giant peritoneal loose body: A case report

Peritoneal loose bodies (PLBs) are uncommon abdominal lesions, typically asymptomatic and discovered incidentally during surgery. Giant PLBs, exceeding 5 cm in size, are even rarer and can present with clinical symptoms mimicking other abdominal pathologies. We present a 57-year-old male with a giant PLB presenting as intermittent abdominal pain, distention, and rectal bleeding. Imaging studies suggested colo-colic intussusception due to a colonic lipoma. The patient underwent an exploratory laparotomy revealing a segment of the descending colon containing multiple lipomas, one causing intussusception. In addition, a separate giant PLB 6 × 5.5 cm with central calcification was identified. A segmental colectomy with primary anastomosis and resection of the PLB was performed. The patient recovered well and reported complete resolution of symptoms at follow-up. Pathology confirmed a benign lipoma and a giant PLB. This case highlights the potential for giant PLBs to cause clinical symptoms and emphasizes the importance of including them in the differential diagnosis of abdominal complaints, even in the absence of a classic presentation. Exploratory laparotomy remains a definitive approach for diagnosis and management in such cases.

Giant peritoneal loose body and its protein composition: a case report

Peritoneal loose body (PLB) is a kind of lesions located in the abdominal cavity or pelvic cavity, which is rare and difficult to diagnose. The diameter of PLB is mostly 0.5–2.5 cm. Most PLBS are asymptomatic. Here we reported a case of giant PLB in the pelvis and analyzed its structure and protein composition. Surgical exploration revealed a white oval mass (4.5*4*3 cm) in the pelvic cavity. After the mass was removed, the symptoms of hematuria disappeared and the patient was discharged on the second postoperative day. Histochemical staining showed that PLB was mainly composed of collagen and scattered calcification. The protein components of PLB were detected by proteome analysis, and a variety of proteins related to collagen deposition and calcification were identified in PLB.

Abdominal mouse in a patient with endometriosis post GnRH therapy

Abstract A 26-year-old unmarried woman complained of pelvic pain and dysmenorrhea. On pelvic examination, her cervix was pulled up with bilateral forniceal tenderness. On ultrasonography, her left ovary showed two 4 cm × 4 cm endometriosis cysts and a negative sliding sign. She was placed on three cycles of GnRH analogs and on laparoscopy showed the presence of peritoneal loose bodies in the pelvis [Figures 1 and 2].

Giant peritoneal loose body: a challenging diagnosis in an asymptomatic patient

Peritoneal loose bodies are rare surgical or imaging findings. In most cases, PLBs are small in size, usually from 5 to 20 mm. Giant PLBs measuring more than 50 mm are even rarer. Only a few cases of giant PLBs have been reported. The authors report a case of a giant PLB with only mild symptoms and with no preoperative diagnosis, highlighting the importance of being aware of the characteristic findings of these lesions to establish a correct diagnosis, avoiding unnecessary surgery.

Giant Peritoneal Loose Body Causing Acute Intestinal Obstruction: Case Report

Peritoneal loose bodies are a rare condition. They are caused by the peritoneal appendages that become inflamed and cause a buildup of material in the peritoneal cavity. This can be hard to spot because it's so rare. The availability of CT scans makes this diagnosis easier. A 77-year-old patient with hypertension and diabetes underwent peritoneal mouse challenge. The patient suffers from acute intestinal sub obstruction. CT scan revealed a mobile calcified density lesion approximately 5 cm in diameter in the peritoneal cavity. Peritoneal loose bodies are a rare complication of omental appendages that have distorted due to ischemic conditions. Laparoscopy excised a firm mass suggestive of primary omental appendicitis. Diagnostic terms for acute or chronic abdominal pain can be found in the general medical literature. Photographs of the affected individual's body show a large greasy or chalky substance.

Giant peritoneal loose body diagnosis by 18F-FDG PET/CT: A case report

An 18F-FDG PET/CT scan performed in a 70-year-old patient for characterization of a pulmonary nodule revealed a very rare image of a giant loose peritoneal body in this asymptomatic patient. A review of literature is presented. The knowledge of the characteristics of this typical lesion is important to avoid further invasive explorations.

Multiple Peritoneal Loose Bodies in a Patient with Stage IV Endometriosis

A 34-year-old no history of pregnancy with suspected stage IV endometriosis presented for surgical management. Laparoscopy showed a frozen pelvis, bilateral endometriomas and dilated fallopian tubes, obliterated anterior and posterior cul-de-sacs, and diffuse diaphragmatic and omental endometriotic implants. Multiple free-floating and adherent masses with smooth yellow-brown surfaces and soft rubbery consistency were observed within the pelvis and tunneled into the peritoneum (Fig. 1), including deep within a bladder peritoneal pocket (Fig.

GIANT PERITONEAL LOOSE BODY IN A PATIENT WITH COVID 19 INFECTION: CASE REPORT

Peritoneal loose bodies have been known to exist for hundreds of years. Peritoneal bodies that reach a diameter of more than 5 cm are referred to as "giant" peritoneal bodies (gPLBs). Even while these massive peritoneal masses are symptom-free in most cases, they may be connected to chronic symptoms such as stomach pain or discomfort. gPLBs are frequently misdiagnosed as intraabdominal malignancies or foreign things, resulting in needless surgical interventions. We discuss an unusual case of a 50-year-old man who was treated for moderate covid 19 infection. During evaluation for Covid infection with HRCT Thorax, a mass lesion was identified in the pelvic cavity. One month after getting cured of covid infection, he presented to our outpatient department for further evaluation of a mass lesion in the pelvic cavity. A contrast-enhanced computed tomography scan of the abdomen and pelvis revealed a 6.5 cm x 5.3 cm oval mass in the pelvis. A firm, free-floating object the size of a boiled egg could be scraped out of the pelvis during laparotomy. The diagnosis of gPLB was confirmed by the postoperative pathological investigation, which revealed a Calcified eosinophilic nodule with lamellations. The postoperative time went without a hitch. Peritoneal bodies are unusual intraabdominal bodies that are discovered by chance or present with a variety of symptoms, demanding interdisciplinary treatment.

Fat-containing pelvic lesions in females.

Pelvic tumors are common in females and have a broad differential diagnosis. The clinical management of pelvic tumors varies widely-from observation to surgical resection-and imaging plays a pivotal role in diagnosis and clinical decision-making in these cases. In particular, imaging can help determine the organ of origin and tissue content of these tumors, which are the most important steps to narrowing the differential diagnosis. Fat has a characteristic appearance and is often easily identified on ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI). The amount and distribution of intralesional fat varies in different types of tumors. Macroscopic intralesional fat is often easily recognized by its hyperechoic appearance on US and low attenuation on CT similar to subcutaneous fat. On MRI, macroscopic fat is hyperintense on T1-weighted (T1W) images, with characteristic signal loss on fat-saturated sequences and India-ink artifact on opposed-phase T1W images. Macroscopic fat is the hallmark of teratomas, which are the most common ovarian neoplasms. Uterine lipoleiomyomas, peritoneal loose bodies, intraperitoneal and extraperitoneal primary lipomatous tumors such as lipoma and liposarcomas, and extra-adrenal myelolipomas are other pelvic masses distinguished by the presence of macroscopic fat. However, the imaging diagnosis of pelvic masses containing minimal or microscopic fat, such as immature ovarian teratomas, steroid cell ovarian neoplasms, and extramedullary hematopoiesis, can present a diagnostic challenge owing to their nonspecific appearance on US or CT. Obtaining MRI with in-phase and opposed-phase dual-echo T1W sequences and depicting chemical shift artifacts can be helpful in distinguishing these lesions.

English

A 50-year-old male patient was referred to Department of Radiodiagnosis for evaluation of a longstanding intermittent abdominal pain associated with a palpable mass migrating in different quadrants of the abdomen and had gradually increased in size over last few years. The initial ultrasonographic (USG) evaluation revealed a well circumscribed bilobed hypoechoic pelvic solid space occupying lesion (SOL) with central calcific foci. Subsequent contrast enhanced computed tomography (CECT) imaging showed a 10.1 x 7.5 x 5.8 cm, bilobed non-enhancing pelvic mass with central dense calcific foci and concentric soft tissue layers of different attenuation. The mass was diagnosed to be a giant peritoneal loose body (gPLB) and confirmed by surgical exploration.

Incidental peritoneal loose body in a polytrauma patient: The unnoticed scenario: A case report.

IntroductionPeritoneal loose bodies are rare, often asymptomatic lesions that can be found during radiologic examinations or abdominal surgery. They don't require specific treatment unless they are complicated.Presentation of caseWe present a rare case of incidentally diagnosed peritoneal loose body in a 38 years old man who undergone exploratory laparotomy for the diagnosis of hypovolemic shock secondary to acute intra-abdominal bleeding with solid organ injury secondary to blunt abdominal trauma and left proximal tibia fracture.DiscussionSymptomatic peritoneal loose bodies present with compressive symptoms of urinary system or bowel obstruction. As a result, they create diagnostic dilemmas in patients with previous history of abdominal surgery who present with acute abdominal pain, commonly confusing with retained foreign body.ConclusionAlthough most incidental loose bodies are diagnosed intraoperatively on laparatomies done for other indications, it's very unusual to suspect such findings in hemodynamically unstable polytrauma patient undergoing surgical exploration. Considering the diagnostic challenges they create in post-operative patients presenting with abdominal complaints, its better practice to consider such rare findings when exploring the abdomen in trauma settings.

Curious Case of Peritoneal Loose Body

Peritoneal loose bodies (PLB) also known as “peritoneal mice”, are rare lesions often found incidentally during laparoscopies or laparotomies. They are often small in size although PLBs measuring in size more than 5 cm have also been reported. Most small PLBs remain asymptomatic and do not require treatment, although large PLBs have also been known to cause symptoms like urinary obstruction, intestinal obstruction. We present one such case of a middle- aged man having a PLB causing subacute intestinal obstruction.

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

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.

An abdominal surprise – A case report

Peritoneal loose bodies (PLBs), also known as peritoneal mice, are rare entity that is basically calcified pieces of necrotic tissue found in the peritoneal cavity. They are thought to evolve from torsion and separation of the appendices epiploicae, which are susceptible to such a process due to their narrow pedicle. We report the case of a 52-year-old male diagnosed as a case of chronic calculous cholecystitis. Workup investigations revealed nothing untoward other than gall stones. The patient was planned for laparoscopic cholecystectomy. Intraoperatively, a solitary smooth 6 cm × 6 cm spherical mass was found in the pelvic cavity not attached to any viscera or abdominal wall. The mass was diagnosed as a PLB. Such an entity is quite rare in medical literature and thus was sought for reporting.

A Rare Case of Peritoneal Loose Body (Mice) in Left Sided Inguinal Hernial Sac

Peritoneal loose bodies or peritoneal mice are calcified pieces of necrotic tissue found in the peritoneal cavity. They are usually asymptomatic and small, ranging from 0.5 to 2.5 cm in size, but rarely may be up to 5 to 10 cm in size [1]. Peritoneal loose bodies almost never cause any symptoms. They are mostly found incidentally during laparotomy [2].

A giant peritoneal loose body impacted in the pelvic cavity, a rare and interesting finding during laparotomy

Background: Peritoneal loose bodies (sometimes termed as peritoneal mice) are rare findings that may be discovered incidentally during laparotomy or at autopsy. They consist of densely hyalinized, laminated, fibrous tissue which is arranged in multiple concentric layers. They arise from epiploic appendices which undergo torsion, ischemia and necrosis, saponification and then calcification. In most patients they cause no symptoms or nonspecific symptoms. Case Presentation: A 67-year-old male presented with lower abdominal pain and constipation for 3 months. Abdominal examination showed a fixed palpable mass in the lower abdomen arising from the pelvic cavity, the mass was firm, not tender and not mobile. Magnetic resonance imaging of the pelvis showed a large lobulated 10×70 cm abdominal mass with no significant enhancement. During laparotomy there was a large smooth and firm intraperitoneal mass which was attached by small pedicle to the omentum. Extraction of the mass was performed. The cut surface of the mass showed multiple concentric layers with a central stone like structure. Histopathologic evaluation revealed extensive fibrous tissue with mild inflammatory cells infiltration and areas of calcifications. Conclusion: The most important critical step in the management of peritoneal loose bodies is to distinguish them from other intraperitoneal masses particularly tumors which is sometimes very difficult and may require some invasive procedures including surgery, surgery may also be required for large symptomatic masses.

TWO RARITIES TOGETHER: A FREE PERITONEAL BODY IN A HERNIA EN PANTALOON SAC AND CASE SERIES OF OUR EXPERIENCE OF FINDING LOOSE PERITONEAL BODIES

Peritoneal loose bodies (PLBs) are rare findings that were reported extensively in the early nineteenth and twentieth century in theform of case series by Littre, Riedel and Macintosh. In the recent past, focus has shifted more towards symptomatic free peritonealbodies. Although a proper intrabdominal examination and histopathology can help to clear the diagnosis, there is still no consensusin the surgical circle as to how to deal with them. Here, we report a case series of 4 cases of finding loose peritoneal bodies duringintra-abdominal procedures, three of them were found during laparoscopic procedures (laparoscopic appendectomy, Robotic meshrectopexy and laparoscopic bowel resection) while one was an open surgery (open inguinal hernia repair). This paper is unique asfor the first time in the history it brings two surgical rarities together i.e. ‘hernia en pantaloon’ and free peritoneal body along withrecommendations based on the literature, review to diagnose and treat loose peritoneal bodies.

Giant peritoneal loose body: A case report.

Peritoneal loose body (PLB) is a rare finding and it is usually incidentally discovered during laparotomy, examination or autopsy, as it is usually asymptomatic or presents with non-specific symptoms. In particular, giant PLBs, measuring >50 mm in maximum diameter, are even more rare, and only a few cases of laparoscopic extraction of these giant bodies have been reported in the literature to date. We herein describe our experience with the diagnosis and treatment of a giant PLB in a 49-year-old male patient who was admitted with complaints of intermittent pain the in lower abdomen 3 months earlier. An abdominal computed tomography scan revealed a 5.5x5.0-cm midline mass with central high density. The diagnosis was confirmed by open surgery and postoperative pathological examination. The postoperative recovery of the patient was uneventful and he was discharged from the hospital 7 days after surgery.

最大径50mmの腹腔内遊離体の1例

症例は65歳，男性，健康診断の腹部超音波検査で腹腔内腫瘤を指摘され，当院を受診した．造影CT・MRIで膀胱腹側に50mm大の腫瘤を認め，腹腔内あるいは腹膜外腔に位置する奇形腫が疑われた．悪性も否定できないため手術の方針とした．開腹手術にて骨盤内を検索したが，明らかな腫瘤は確認できなかった．しかし，術直後の腹部X線写真で左側腹部に移動した石灰化腫瘤を認めたため，直ちに再手術にて大きさ50mm大の腹腔内遊離体を摘出した．50mm大を超える腹腔内遊離体は稀であり，術前に診断がついたものは少ない．典型的な画像所見と移動が確認されれば診断は可能であり，症状を呈さなければ不要な手術を避けることが可能である．腹腔内腫瘤の鑑別として近年腹腔鏡の有用性が報告されてきているが，いずれにしても本疾患の存在を念頭に置くことが第一である．