Sewkani et al. Journal of Medical Case Reports 2011, 5:297 http://www.jmedicalcasereports.com/content/5/1/297 Page 2 of 3 Figure 1 Macrograph showing location of the ‘boiled egg’ (Giant loose peritoneal body) in the abdomen which was something of a surprise to the operating surgeon during exploration and adhesiolysis for acute intestinal obstruction. (parasitized) to the omentum (Figure 2). In addition, part of the appendices epiploicae, attached to his sigmoid colon, were calcified with constricted stalks. The perito- neal loose body was largely parasitized to the omentum with a separate feeding vessel supplying it from the omentum. The body was an oval shaped mass, measuring 7 cm in length and 5 cm in width, and weighed 74 g. On the cut surface, it had classic appearance like a boiled egg, with a distinct white peripheral part and yellow central part (Figure 3). The white part was smooth and soft in consistency while the central yellow part was slightly firm in the periphery and hard (calcified) at the central point. The surfaces were smooth and shiny. On Figure 2 Macrograph showing giant peritoneal loose body parasitized to omentum. The macrograph clearly shows the giant loose body attached to omentum and a separate twig from omentum supplying to loose peritoneal body. Figure 3 Macrograph of giant loose body (cut surface) showing peripheral white & central yellow portions resembling a boiled egg. histological examination, it consisted of laminated strands of a fibrinoid substance with a large amount of proteinaceous material in the peripheral white part (boiled albumin with a high collagen deposition) and saponified fat with calcification in the central yellow part. Our patient did well post-operatively; he resumed his oral diet on the third post-operative day. He was dis- charged from the hospital five days after the operation. Discussion Giant loose bodies (peritoneal mice) are very rare and only a few cases have been reported in literature [1-10]. The exact pathogenesis of loose bodies has not been fully demonstrated, however the current hypothesis as mention previously by many authors [6,8-10] suggests that it is a sequential process which starts with torsion of an epiploica, followed by ischemia, saponification and calcification. The pedicle atrophies and finally it detaches from the colon surface to become a loose body. We believe that once an appendix epiploica gets sapo- nified and calcified the exudative serum fluid (rich in protein) accumulates around it and, because of increased temperature in the peritoneal cavity, it gives the appearance of a boiled egg. With time, the size of the peritoneal body increases because of a gradual deposition of body serum at the periphery. Sometimes the free peritoneal body attaches to the omentum and receives a blood supply from it (a parasitized peritoneal body), as in our case. Our histological findings suggest that saponified and calcified appendices epiploicae form the yellow central part and gradual deposition of peritoneal serum around it form the outer white layer, hence giving the appear- ance of a boiled hen’s egg.