Laparoscopic Surgery for a Peritoneal Loose Body 50 mm in Diameter —A Case Report—

Abstract

A 78-year-old male patient with a history of BPH had a routine medical examination. On radiological examination, a mass, 50 mm in diameter, was observed in the pelvic cavity. Therefore, a provisional diagnosis of a leiomyoma or a peritoneal loose body was made. Laparoscopy was performed. A white, egg-shaped peritoneal loose body was extracted ; it was completely free in the pelvic cavity. Histologically, this body consisted of many layers of laminated fibrous tissue with central necrotic fatty lesions. It likely originated from a free necrotic appendice epiploicae. Peritoneal loose bodies are often seen as unique images on X-ray examination due to the presence of fibrous tissue layers surrounding fat necrosis and calcification. It is fortunate that minimally invasive laparoscopic surgery is an available option when a peritoneal loose body is suspected preoperatively.