Snapshot in surgery: intraperitoneal encapsulated fat necrosis

Area of Science:

• Gastroenterology
• Surgical Pathology
• Abdominal Imaging

Background:

• Incidental findings during cancer staging can present diagnostic challenges.
• Encapsulated fat necrosis is a rare condition, often asymptomatic.
• Understanding the etiology of free-floating intraperitoneal lesions is crucial for accurate diagnosis.

Purpose of the Study:

• To report a case of incidentally discovered encapsulated fat necrosis in the rectovesical pouch.
• To discuss the potential pathogenesis of intraperitoneal encapsulated fat necrosis.
• To highlight the importance of histological examination for diagnosing such lesions.

Main Methods:

• A 66-year-old male patient with rectal cancer underwent imaging and subsequent surgical evaluation.
• Histopathological examination of an incidentally found ring-like lesion was performed.
• Review of relevant literature on intraperitoneal encapsulated fat necrosis.

Main Results:

• An incidental, ring-like lesion was identified in the left rectovesical pouch.
• Histology confirmed the lesion as encapsulated fat necrosis.
• The lesion was postulated to be a free-floating entity originating from an infarcted epiploic appendage.

Conclusions:

• Encapsulated fat necrosis can present as an incidental finding in the rectovesical pouch.
• Infarcted epiploic appendages are a likely cause of free-floating intraperitoneal fat necrosis.
• Accurate diagnosis relies on thorough histopathological analysis.