Giant peritoneal loose body in a patient with end-stage renal disease

Cojocari, Nadejda; Diller, Leonard

doi:10.1177/2050313x18770936

Cited by 3 publications

(1 citation statement)

References 15 publications

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“…In some instances, they have been documented to grow larger than 5 cm in diameter, secondary to absorption of protein in peritoneal fluid. 5 Although peritoneal loose bodies are fairly uncommon, and are often discovered incidentally, 6 it should be noted that the possibility for compressive complications exists, and the differential of possible non-benign primary or metastatic lesions should be entertained. The differential diagnosis includes calcified uterine fibroids, desmoid tumours, teratomas, fecaliths or even metastasis from ovarian cancer that should be considered in the appropriate patient population, and the need for further cross-sectional imaging or intervention individualised depending on the certainty of the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Giant peritoneal loose body : an instance of incidentaloma or warranted concern?

Allopi¹,

Fataar²,

Kimmie³

2021

South African Journal of Surgery

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A 79-year-old male, diagnosed with essential hypertension, was referred with a long-standing history of abdominal pain, colicky and global in radiation, accompanied by anorexia and loss of weight of approximately 5 kg in two years. On further inquiry, he reported no lower urinary tract or obstructive symptoms. He had had no prior hospital admission or surgical intervention. He reported no family history of cancer and is a teetotaller.His general and systemic examination was unremarkable. In particular, he had no features of wasting or anaemia. His vital signs were normal. Abdominal examination revealed a fullness, with impression of mass, in the right lower quadrant, but no signs of peritonism. On digital rectal examination the prostate was smooth and firm with no other abnormality.His abdominal radiographs showed calcifications in the pelvis that were thought to be phleboliths. His baseline blood tests showed no anaemia, normal renal function and normal value tumour markers. An outpatient upper endoscopy and colonoscopy were normal. A CT abdomen was then requested, which showed a well-defined mass measuring 6.74 x 7.9 x 8.18 cm, with a central area of calcification with a differential diagnosis of a teratoma or non-benign lesion (Figure 1).Due to the uncertainty of diagnosis and suspicion of nonbenign lesion, the patient was counselled and consented SummaryIn non-specific abdominal pain, cross-sectional imaging, often valued more than clinical examination in today's technologically advanced age, may reveal a large incidentaloma, posing questions regarding its relation to symptoms and the need for surgical removal. This is a situation that highlights the potential for early detection and treatment yet raises the question as to whether surgery is indeed indicated. This report relates the case of a 79-year-old male, with a longstanding history of abdominal pain, who had a giant loose peritoneal body removed. We discuss the reasons for removal and its pathogenesis.

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Section: Discussionmentioning

confidence: 99%

Giant peritoneal loose body : an instance of incidentaloma or warranted concern?

Allopi¹,

Fataar²,

Kimmie³

2021

South African Journal of Surgery

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A Case of a Fixed Giant Peritoneal Loose Body outside the Peritoneum and near the Rectovesical Excavation

et al. 2023

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A peritoneal loose body (PLB) is a tissue completely separated from other intraperitoneal organs. It is rare and usually found incidentally during laparotomy, examination, or autopsy. It is usually located free in the peritoneal cavity and does not exist in the extraperitoneal space. It is generally thought to originate from the epiploic appendices released into the abdominal cavity following ischemic necrosis. We report a case of a giant PLB outside the peritoneal cavity, adjacent to the rectovesical excavation, in an asymptomatic 83-year-old man who underwent evaluation for cholecystolithiasis, preoperatively. Computed tomography revealed a mass with well-defined margins in the rectovesical excavation, consisting of a calcified core and peripheral soft tissue measuring 60 mm in diameter; it did not seem to invade adjacent organs. Although there were no symptoms or tumor growth over time, for a definitive diagnosis, we scheduled a laparoscopic extraction. On laparoscopic exploration, a white oval mass was found in the rectovesical excavation; there was no invasion of adjacent organs. We diagnosed the patient with a giant PLB. Postoperative recovery was uneventful. Most PLBs are asymptomatic and do not require surgery except when symptomatic, large in size, or

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Peritoneal loose body presenting as a hepatic mass: A case report and review of the literature

Wen

Shang

et al. 2021

Open Medicine

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Peritoneal loose body (PLB) is a rare clinical entity. It is generally agreed that the most common origin of the loose bodies is appendix epiploica. We here report a case of PLB that looks like a “boiled egg,” which was misdiagnosed preoperatively as a lesion of hepatic origin and was confirmed by operation and postoperative pathology. PLBs are rare entities, a good understanding of their specific imaging features can help prevent misdiagnosis, but sometimes an accurate preoperative diagnosis is still difficult to achieve. Exploratory laparoscopy is a recommended method for management of PLBs.

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Giant peritoneal loose body in a patient with end-stage renal disease

Cited by 3 publications

References 15 publications

Giant peritoneal loose body : an instance of incidentaloma or warranted concern?

Giant peritoneal loose body : an instance of incidentaloma or warranted concern?

A Case of a Fixed Giant Peritoneal Loose Body outside the Peritoneum and near the Rectovesical Excavation

Peritoneal loose body presenting as a hepatic mass: A case report and review of the literature

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