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

INTRODUCTION: A peritoneal loose body is a rare finding and is sometimes founded incidentally during laparotomy or autopsy. A giant peritoneal loose body, measuring more than 50 mm, is very rare, and only a few cases of laparoscopic extraction of these giant bodies have been reported in the literature. PRESENTATION OF CASE: A 70-year-old man presented for evaluation of urinary frequency. He had no history of previous abdominal surgery or trauma. Computed tomography of the abdomen and pelvis showed a giant oval-shaped mass with calcification of the luminal core, measuring 58 mm in diameter. Magnetic resonance imaging revealed a lesion with low intensity in T1-/T2-weighted images. Exploratory laparoscopy was performed. During the procedure, a yellow-white, oval-shaped mass with a “Boiled egg” appearance was discovered in front of the rectum. The mass was freely floating in the peritoneal cavity, without attachment to any intraperitoneal organs. The giant peritoneal loose body was extracted through a small incision, using an enlarged trocar site. DISCUSSION: Most peritoneal loose bodies are small, not exceeding 2 cm in diameter, and are asymptomatic. Only a few cases of giant peritoneal loose bodies exceeding 5 cm have been reported. CONCLUSION: A giant peritoneal loose body is very rare and laparoscopic extraction was a useful technique. We report a case of a giant peritoneal loose body and review previously published series.