Giant Peritoneal Loose Body with Its Snowball Effect - A Rare Case Report

We present a rare case of a 55-year-old unmarried woman with a giant loose peritoneal body, who presented with an unusual constellation of symptoms such as a palpable abdominal mass, increased frequency of micturition, urinary incontinence, and bilateral pedal edema. These symptoms gradually worsened over time, significantly impacting her quality of life. Clinical evaluation and imaging studies revealed the presence of a large, freely mobile peritoneal mass.

The patient underwent an exploratory laparotomy, during which the loose peritoneal body was identified and removed. This case is notable due to the exceptional size and weight of the peritoneal body, resembling a boiled ostrich egg, weighing 1.05 kg and measuring 16 x 14.5 x 11 cm. To our knowledge, this is the world’s largest peritoneal loose body reported in the literature. Histopathological examination confirmed its benign nature. Remarkably, postoperatively, the patient experienced complete resolution of her symptoms. This highlights the importance of surgical intervention in symptomatic or suspicious cases, which can result in significant symptomatic relief.

Loose peritoneal bodies are exceedingly rare, particularly when they reach such significant size, and are often asymptomatic until they impinge upon surrounding structures. This case underscores the importance of considering this entity in the differential diagnosis of patients presenting with atypical abdominal or urinary complaints. Early recognition and surgical removal are crucial in preventing further complications and ensuring symptomatic relief.