Peritoneum, Peritoneal mice [LMP54480]

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Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Cellular Responses to Stress and Toxic Insults: Adaptation, Injury, and Death
Diagnosis: 
Peritoneal mice
Species: 
Human
Organ System: 
Gastrointestinal Tract
Gender: 
Male
Age: 
66 years
Diagnosis Code: 
ICD-10: M99.9
Slide Contributor Information
Basheer, M., Riddell, R.

Keywords

loose peritoneal bodies, epiploic appendage, appendix epiploica

Clinical History

66 year-old man with history of colon cancer and anastomotic stricture who underwent redo anterior resection. Multiple well-circumscribed ovoid nodules were identified within the adjacent adipose tissue, which measured up to 1.3 cm.

Clinical Discussion

Peritoneal mice, also known as loose peritoneal bodies, are 0.5-2.5 cm benign lipid-containing appendiceal epiploicae present along the entire length of the colon. These can be asymptomatic and found incidentally on autopsies or laparotomies, or may present symptomatically with abdominal pain. One of the proposed etiologic theories postulated by Virchow (1863) outlines a process by which the increase in fat content of appendiceal epiploicae leads to obstruction of blood vessels of the pedicle. Subsequent torsion and strangulation occurs where the pedicle detaches from the colon and forms loose peritoneal bodies. Microscopic findings include necrotic, infarcted adipose tissue circumscribed by a thick inflamed fibrous tissue.