Ariaya Abraham, Ahmed Musse, Mindaye Esubalew Taddese
Department of Surgery, Saint Paul's Hospital Millennium Medical College, Swaziland Street 1271, Addis Ababa, Ethiopia.
Department of Surgery, Saint Paul's Hospital Millennium Medical College, Swaziland Street 1271, Addis Ababa, Ethiopia.
Int J Surg Case Rep. 2021 Aug;85:106158. doi: 10.1016/j.ijscr.2021.106158. Epub 2021 Jun 29.
Peritoneal loose bodies are rare, often asymptomatic lesions that can be found during radiologic examinations or abdominal surgery. They don't require specific treatment unless they are complicated.
We present a rare case of incidentally diagnosed peritoneal loose body in a 38 years old man who undergone exploratory laparotomy for the diagnosis of hypovolemic shock secondary to acute intra-abdominal bleeding with solid organ injury secondary to blunt abdominal trauma and left proximal tibia fracture.
Symptomatic peritoneal loose bodies present with compressive symptoms of urinary system or bowel obstruction. As a result, they create diagnostic dilemmas in patients with previous history of abdominal surgery who present with acute abdominal pain, commonly confusing with retained foreign body.
Although most incidental loose bodies are diagnosed intraoperatively on laparatomies done for other indications, it's very unusual to suspect such findings in hemodynamically unstable polytrauma patient undergoing surgical exploration. Considering the diagnostic challenges they create in post-operative patients presenting with abdominal complaints, its better practice to consider such rare findings when exploring the abdomen in trauma settings.
腹膜游离体罕见，通常无症状，可在影像学检查或腹部手术中发现。除非出现并发症，否则无需特殊治疗。
我们报告一例罕见病例，一名38岁男性因钝性腹部外伤继发实体器官损伤和左胫骨近端骨折导致急性腹腔内出血继发低血容量性休克，接受剖腹探查术时偶然诊断出腹膜游离体。
有症状的腹膜游离体表现为泌尿系统压迫症状或肠梗阻。因此，对于有腹部手术史且出现急性腹痛的患者，它们会造成诊断难题，常与残留异物相混淆。
尽管大多数偶然发现的游离体是在因其他指征进行的剖腹手术中术中诊断出来的，但在接受手术探查的血流动力学不稳定的多发伤患者中怀疑有此类发现非常罕见。考虑到它们给出现腹部不适的术后患者带来的诊断挑战，在创伤情况下探查腹部时考虑此类罕见发现是更好的做法。
