Imaging Manifestation and Pathological Comparison of the Peritoneal
Loose Body: A Case Report and Review of the Literature

Xiaoran      Li; Hui      Wu; Shuwen      Wang; Jing      Wu; Yu-Chen      Chen

doi:10.2174/1573405619666221125153408

Abstract

Background: Peritoneal loose body (PLB) which is also called "peritoneal mouse" is a rare disease, with only a few cases reported. PLB is mostly found due to unplanned examination, surgery, or autopsy. With the increase in abdominal imaging examinations, it was gradually recognized by us. The diagnosis of PLB has three major characteristics: free movement, no blood supply, and pathological exclusion of other tumors.

Case Presentation: We reported a 66-year-old male patient with an asymptomatic freely moving peritoneal loose body. The size of the lesion was about 4*4cm. The imaging data were complete including Ultrasound, Magnetic resonance (MR), Computed tomography (CT) plain scan and enhancement. Interestingly, changes in the location of the lesion were found on follow-up CT. The lesion showed concentric circles changes on CT without obvious enhancement. MR also appeared as a multi-layer signal of concentric circles. In addition, the imaging manifestations were compared with histological pathology in this article to explain imaging characteristics.

Conclusion: PLB is an uncommon disease. Through the complete imaging examination of this case, we can further understand the mobility of the lesion by changing the position. The CT and MR have characteristic concentric circle changes without obvious enhancement. The diagnosis could be confirmed before surgery, which prompted the clinical early diagnosis of the disease, and an appropriate choice between surgery and conservative treatment.

[1]
Ghahremani GG, White EM, Hoff FL, Gore RM, Miller JW, Christ ML. Appendices epiploicae of the colon: Radiologic and pathologic features. Radiographics  1992; 12(1): 59-77.
 [http://dx.doi.org/10.1148/radiographics.12.1.1734482] [PMID:  1734482]

[2]
Sewkani A, Jain A, Maudar KK, Varshney S. ‘Boiled egg’ in the peritoneal cavity-a giant peritoneal loose body in a 64-year-old man: A case report. J Med Case Reports  2011; 5(1): 297.
 [http://dx.doi.org/10.1186/1752-1947-5-297] [PMID:  21736712]

[3]
Hunt VC. Torsion of appendices epiploicae. Ann Surg  1919; 69(1): 31-46.
 [http://dx.doi.org/10.1097/00000658-191901000-00008] [PMID:  17864042]

[4]
Thejeswi P, Thejeswi P, Prabhu S, Bhat RR. Giant peritoneal loose body: A case report and review of literature. J Clin Diagn Res  2014; 8(1): 187-8.
 [http://dx.doi.org/10.7860/JCDR/2014/7352.3925] [PMID:  24596768]

[5]
Gayer G, Petrovitch I. CT diagnosis of a large peritoneal loose body: A case report and review of the literature. Br J Radiol  2011; 84(1000): e83-5.
 [http://dx.doi.org/10.1259/bjr/98708052] [PMID:  21415299]

[6]
Desai HP, Tripodi J, Gold BM, Burakoff R. Infarction of an epiploic appendage. Review of the literature. J Clin Gastroenterol  1993; 16(4): 323-5.
 [http://dx.doi.org/10.1097/00004836-199306000-00012] [PMID:  8331268]

[7]
Elsner A, Walensi M, Fuenfschilling M, Rosenberg R, Mechera R. Symptomatic giant peritoneal loose body in the pelvic cavity: A case report. Int J Surg Case Rep  2016; 21: 32-5.
 [http://dx.doi.org/10.1016/j.ijscr.2016.02.013] [PMID:  26901087]

[8]
Cheng Y, Qu L, Li J, Wang B, Geng J, Xing D. Abdominal cocoon accompanied by multiple peritoneal loose body. Medicine  2017; 96(9): e6185.
 [http://dx.doi.org/10.1097/MD.0000000000006185] [PMID:  28248873]

[9]
Koga K, Hiroi H, Osuga Y, Nagai M, Yano T, Taketani Y. Autoamputated adnexa presents as a peritoneal loose body. Fertil Steril  2010; 93(3): 967-8.
 [http://dx.doi.org/10.1016/j.fertnstert.2009.03.038] [PMID:  19394607]

[10]
Rubinkiewicz M, Kenig J, Zbierska K, Lasek A. Autoamputated leiomyoma of the uterus as a rare cause of the mechanical bowel obstruction - report of a case. Pol Przegl Chir  2014; 86(7): 341-4.
 [http://dx.doi.org/10.2478/pjs-2014-0060] [PMID:  25222583]

[11]
Huang Q, Cao A, Ma J, Wang Z, Dong J. Two giant peritoneal loose bodies were simultaneously found in one patient: A case report and review of the literature. Int J Surg Case Rep  2017; 36: 74-7.
 [http://dx.doi.org/10.1016/j.ijscr.2017.05.004] [PMID:  28550786]

[12]
Mayfield J, Schammel C, Yurko Y, Schammel DP, Devane AM. Peritoneal loose bodies and the differentiation of fatty abdominal and pelvic lesions. Radiol Case Rep  2020; 15(9): 1506-11.
 [http://dx.doi.org/10.1016/j.radcr.2020.06.040] [PMID:  32670450]

[13]
Ooyagi H, Ishida H, Komatsuda T, et al. Peritoneal loose body. J Med Ultrason  2006; 33(3): 189-90.
 [http://dx.doi.org/10.1007/s10396-006-0109-8]

[14]
Sussman R, Murdock J. Images in clinical medicine. Peritoneal loose body. N Engl J Med  2015; 372(14): 1359.
 [http://dx.doi.org/10.1056/NEJMicm1316094] [PMID:  25830426]

[15]
Rosic T, Khumalo V, Nethathe DG. A pelvic “loose” body tumour causing urinary symptoms in a 73-year-old man. S Afr J Surg  2016; 54(2): 53-4.
 [PMID:  28240507]

[16]
Takayama S, Sakamoto M, Takeyama H. Clinical challenges and images in GI. Image 1: huge peritoneal loose body in the pelvic cavity. Gastroenterology  2009; 136(2): 404.
 [http://dx.doi.org/10.1053/j.gastro.2008.04.014]

[17]
Nomura H, Hata F, Yasoshima T, et al. Giant peritoneal loose body in the pelvic cavity: Report of a case. Surg Today  2003; 33(10): 791-3.
 [http://dx.doi.org/10.1007/s00595-003-2573-8] [PMID:  14513332]

Rights & Permissions Print Cite

Journal Information

For Authors

For Editors

For Reviewers

Explore Articles

For Visitors

DOI https://dx.doi.org/10.2174/1573405619666221125153408	Print ISSN 1573-4056
Publisher Name Bentham Science Publisher	Online ISSN 1875-6603

Current Medical Imaging

Imaging Manifestation and Pathological Comparison of the Peritoneal Loose Body: A Case Report and Review of the Literature

Abstract Play Pause

Related Books

Abstract