Laparoscopic extraction of a giant peritoneal loose body: Case report and review of literature

Matsubara, Keiso; Takakura, Yuji; Urushihara, Takashi; Nishisaka, Takashi; Itamoto, Toshiyuki

doi:10.1016/j.ijscr.2017.08.033

Cited by 16 publications

(12 citation statements)

References 19 publications

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“…However, the resulting compression of the surrounding organs can lead to mild clinical manifestations, including abdominal pain, intestinal obstruction, urinary retention, and frequent urination. 2,3 Very few cases of GPLB have been reported worldwide. Given that most GPLBs probably remain undetected throughout the patient's life, it is difficult to estimate the probability of its occurrence and it is unlikely to be prevented.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Exploratory laparoscopy has been widely used by surgeons for the detection and management of PLBs. 2 , 4 , 6 , 9 – 14 The use of laparoscopic procedures is currently increasing, 2 , 10 and laparoscopic surgery can reduce surgical damage, minimize postoperative complications, and shorten recovery time. 15 The current patient was discharged from hospital 3 days after surgery, and his complaint of frequent urination resolved during the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

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Exploratory laparoscopy as first choice procedure for the diagnosis of giant peritoneal loose body: a case report

Ruibin

Wan

2020

J Int Med Res

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Peritoneal loose body (PLB) is an extremely rare clinical entity, and its preoperative diagnosis is often difficult. We report a case of giant PLB (GPLB) confirmed by exploratory laparoscopy. A 46-year-old man was admitted to hospital with an abdominal mass and urinary frequency. He underwent clinical and laboratory tests and computed tomography (CT), which indicated a lesion at the bottom of the bladder. Exploratory laparoscopic surgery revealed a GPLB, which was subsequently removed. The patient was comfortable after surgery and was discharged 3 days later. His symptoms of frequent urination improved during the 1-month follow-up period. The egg-shaped mass excised from the peritoneal cavity measured 45 × 40 × 33 mm. This case indicates that exploratory laparoscopy can be considered as the first-choice diagnostic procedure for patients with GPLB.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Exploratory laparoscopy as first choice procedure for the diagnosis of giant peritoneal loose body: a case report

Ruibin

Wan

2020

J Int Med Res

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“…The exact origin of peritoneal loose bodies is unknown, but many authors suggest that they form from a detached appendix epiploicae secondary to torsion and ischemia followed by saponification, calcification, and fibrosis, with gradual increase in size as a result of albumin accumulation from exudative peritoneal fluid [ 4 , 3 ]. It was also reported that giant peritoneal bodies in females can arise from auto-amputated adnexa or a uterine leiomyoma [ 5 ]. Rarely, peritoneal bodies receives blood supply from attachment to the surrounding omentum (a parasitized peritoneal body) [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Deciding to Remove or Leave a Peritoneal Loose Body: A Case Report and Review of Literature

Obaid

Gehani

2018

Am J Case Rep

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Patient: Male, 58Final Diagnosis: Peritoneal loose bodySymptoms: Abdominal pain • hematuriaMedication: —Clinical Procedure: Diagnostic laparoscopySpecialty: SurgeryObjective:Unusual clinical courseBackground:Peritoneal loose bodies, also known as peritoneal mice, are rare findings and they present either with nonspecific symptoms or are found incidentally during exploration and autopsy. Usually, they have no clinical significance and require no specific treatment. We report a case of a giant peritoneal loose body found incidentally in the abdominal cavity of a patient who presented with abdominal pain and hematuria.Case Report:Our patient was a 58-year-old man who presented with abdominal pain and hematuria. Abdominal non-contrast computed tomography (CT) and subsequent CT abdomen and pelvis with intravenous and oral rectal contrast were performed preoperatively, showing a well-circumscribed and calcified lesion of undetermined etiology in the abdominal cavity. The lesion was removed laparoscopically with no complications. Histopathologically, the lesion was reported as calcified tissue with fat necrosis, most likely an infarcted appendix epiploicae.Conclusions:Loose peritoneal bodies can present a challenging diagnostic problem to the surgeon, with confusing findings that can point towards malignancy. It often requires a number of investigations; however even with these investigations, operative exploration, either open or laparoscopic, can be the ultimate diagnostic and therapeutic modality, and the mobility of these calcified lesions may give a preoperative clue to the etiology. It is important to distinguish peritoneal loose bodies from neoplastic or metastatic lesions and to consider it in the differential diagnosis of a calcified mobile pelvic mass. Laparoscopic surgery is safe and effective in the retrieval of symptomatic peritoneal loose bodies.

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“…Given the frequency of indeterminate differentials following imaging for PBLs, we focused on the development of a simple algorithm to identify these rare manifestations ( Fig. 5 ) [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] . Based on the literature review, MRI early in the diagnostic pathway is beneficial.…”

Section: Literature Reviewmentioning

confidence: 99%

Peritoneal loose bodies and the differentiation of fatty abdominal and pelvic lesions

Mayfield

Schammel²,

Yurko

et al. 2020

Radiology Case Reports

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Peritoneal loose bodies (PLBs) have been sparingly documented within the surgical and radiologic literature, with 38 cases reported to date. A 67-year-old male presented to urology for the management of an asymmetric prostatic nodule. Imaging incidentally identified a well-circumscribed mass of low T2 signal intensity with a small fatty core in the left lower quadrant close to the sigmoid colon; malignancy was in the differential. The mass grew slightly over the next year. A diagnostic laparoscopy retrieved a free floating 4 × 4 cm benign mass from the pelvis, identified as necrotic fat with areas of dystrophic calcifications. PLBs are often a diagnostic dilemma without surgical intervention. Here we present a diagnostic algorithm based on a comprehensive literature review and our case to help better identify unknown abdominal and pelvic fatty masses and to avoid surgery strictly for diagnosis, especially for patients that are not ideal surgical candidates. Using this algorithm, the mass in the patient presented here could have been accurately characterized without invasive diagnostic measures.

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Laparoscopic extraction of a giant peritoneal loose body: Case report and review of literature

Abstract: HighlightsLaparoscopic extraction of a giant peritoneal loose body is a good adaption, even if with no symptom.

Cited by 16 publications

References 19 publications

Exploratory laparoscopy as first choice procedure for the diagnosis of giant peritoneal loose body: a case report

Exploratory laparoscopy as first choice procedure for the diagnosis of giant peritoneal loose body: a case report

Deciding to Remove or Leave a Peritoneal Loose Body: A Case Report and Review of Literature

Peritoneal loose bodies and the differentiation of fatty abdominal and pelvic lesions

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