title: Peritoneal mice implicated in intestinal obstruction: report of a case and review of the literature.
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.
  
  
  METHODS
  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 x 4.5 x 3.7 cm and 5.2 x 4.5 x 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, University of California, San Diego, 92161, USA.
authors.forename: Pradipta
authors.initials: P
authors.lastname: Ghosh
authors.forename: Curtis
authors.initials: C
authors.lastname: Strong
authors.forename: Willscott
authors.initials: W
authors.lastname: Naugler
authors.forename: Parviz
authors.initials: P
authors.lastname: Haghighi
authors.forename: John M
authors.initials: JM
authors.lastname: Carethers
mesh_terms: D002114:Calcinosis / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed