A Case of a Peritoneal Loose Body (8.5×7 cm) Presented with Acute Urinary Retention

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  • 尿閉を伴った腹腔内遊離体（8.5×7cm）の1例
  • 症例 尿閉を伴った腹腔内遊離体(8.5×7 cm)の1例
  • ショウレイ ニョウヘイ オ トモナッタ フクコウ ナイ ユウリタイ(8.5 × 7 cm)ノ 1レイ
  • A Case of a Peritoneal Loose Body (8.5×7 cm) Presented with Acute Urinary Retention

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A 63-year-old man who presented to the Department of Urology in our hospital because of a sense of urinary urgency was found to have a 7-cm calcified tumor in the vesicorectal fossa by a MRI study. The tumor was diagnosed as giant peritoneal loose body from its morphology and location. Since the patient was asymptomatic, his clinical course had been observed. Two months later, dysuria and abdominal pain developed and the patient was seen at our hospital again. Blood analysis revealed a high level of inflammatory reaction and severe decline of the renal function. Based on these findings with those of CT, postrenal failure and acute pyelonephritis due to a peritoneal loose body in the pelvic cavity were diagnosed. In order to improve his general condition, a nephrostomy was created in the urological department and then the pelvic loose body was removed in our surgical department. The removed specimen was 85×70 mm in size. Pathologically, a peritoneal loose body was confirmed. Even after removal of the nephrostomy, no aggravation of renal function occurred, and conservative therapy for urinary urgency was successful.<BR>Peritoneal loose bodies are usually silent and can be indicated observation of the clinical course. However, a giant loose body like in our case can invade into the pelvic cavity to cause symptoms including acute urinary retention and constipation. In such cases, we must consider to perform surgical removal before development of symptoms.

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