Peritoneal Mice Implicated in Intestinal Obstruction: Report of a Case and Review of the Literature

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Abstract

Background

Peritoneal loose bodies or “peritoneal mice” are asymptomatic and mostly found as “incidentalomas” during intraperitoneal surgery or at autopsy. Implication of these concretions in an acute abdomen is a rare clinical entity.

Case Report

We report the case of a 63-year-old man who presented with small bowel obstruction and two calcified concretions in his pelvis. A computerized tomography scan demonstrated two oval stones near the terminal ileal loop with lumenal compression of the distal small bowel. During laparotomy, two extralumenal glistening stones, measuring 5.8×4.5×3.7 cm and 5.2×4.5×3.7 cm, were recovered from the peritoneal cavity. Histologically, the wall showed concentric lamellar fibrosis and calcification, whereas the nucleus displayed the vestiges of membranous fat necrosis; all consistent with diagnosis of peritoneal loose body. All symptoms of bowel obstruction were relieved postoperatively, and the patient had an uneventful recovery.

Discussion

Peritoneal loose body is a histopathologic diagnosis, and most other differentials for calcified intraperitoneal masses can be ruled out during the histologic examination. Surgical removal is recommended because conventional cross-sectional imaging cannot accurately establish the diagnosis.

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