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27 August 2026 : Case report  Jordan

[In Press] Unexpected Peritoneal Loose Body Discovered During Laparoscopic Varicocelectomy: A Case Report

Challenging differential diagnosis, Unusual setting of medical care, Rare coexistence of disease or pathology

Jad K. Alsmadi ORCID logo12ABEF, Anas A. Al-Bdour2BF, Ahmad F. Abuo’waida2EF

DOI: 10.12659/AJCR.954629

Am J Case Rep In Press; DOI: 10.12659/AJCR.954629  

Available online: 2026-08-27, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

Abstract

BACKGROUND
Peritoneal loose bodies (PLBs) are rare, benign intraperitoneal entities usually discovered incidentally during abdominal surgery or imaging. Their occurrence during urologic laparoscopy appears to be infrequently reported and may create intraoperative diagnostic uncertainty when encountered unexpectedly.
CASE REPORT
A healthy 22-year-old Jordanian man with no history of abdominal or pelvic surgery underwent bilateral laparoscopic varicocelectomy for symptomatic varicoceles. Dense sigmoid adhesions over the left internal inguinal ring required careful adhesiolysis to expose the spermatic vessels. During dissection, a smooth, freely mobile ovoid structure was identified within the left paracolic gutter and retrieved laparoscopically. Histopathological examination demonstrated necrotic adipose tissue with dystrophic calcification, confirming a PLB. The patient recovered uneventfully and reported resolution of his preoperative symptoms at the 3-week postoperative follow-up.
CONCLUSIONS
This report highlights that a PLB may be encountered unexpectedly even in a healthy patient with no history of abdominal or pelvic surgery who is undergoing an elective, limited-field laparoscopic urologic procedure. In the present case, the lesion’s smooth surface, complete mobility, lack of visible vascular attachment, and firm, rubbery consistency supported intraoperative consideration of a benign PLB. This observation supports awareness that a similar freely mobile, avascular intraperitoneal body encountered unexpectedly during laparoscopy may represent a benign PLB; however, broader management implications cannot be established from a single case. Histopathological confirmation remains important when the diagnosis is uncertain.

Keywords: Laparoscopy; Minimally Invasive Surgical Procedures; Peritoneal Neoplasms; Varicocele

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923