A case of intestinal obstruction caused by a peritoneal loose body mimicking gallstone ileus

Peritoneal loose bodies (also known as peritoneal mice) are usually small in size, ranging from 0.5 to 2.5 cm, and asymptomatic. They have been reported to grow to larger dimension causing symptoms such as acute urine retention (1-2), and abdominal pain (3-4). We report a rare case presenting initially as gallstone ileus. Final diagnosis at exploratory laparotomy was a peri- toneal loose body causing intestinal obstruction. A 69-year-old woman presented to the emergency department, complaining of abdominal pain with nausea and vomiting since midnight. Her medical history was significant for acute appendicitis with rupture and gen- eral peritonitis 50 years previously and status post hys- terectomy 30 years previously for myomatous uterus. She had two episodes of intestinal obstruction in recent 3 years which were resolved after conservative manage- ment.