Lithopedion Causing Intestinal Obstruction in a 71-Year-Old Woman: A Case Report

Abstract

Ectopic pregnancy is the leading cause of pregnancy-related death during the first trimester, and it occurs in 1 to 2% of pregnancies. Over 90% of ectopic pregnancies are located in the fallopian tube. Abdominal pregnancy refers to an ectopic pregnancy that has implanted in the peritoneal cavity, external to the uterine cavity and fallopian tubes. The estimated incidence is 1 per 10,000 births and 1.4% of ectopic pregnancies. Lithopedion is a rare type of ectopic pregnancy, and it occurs when the fetus from an unrecognized abdominal pregnancy may die and calcify. The resulting "stone baby" may not be detected for decades and may cause a variety of complications. Lithopedion is a very rare event that occurs in 0.0054% of all gestations. About 1.5 to 1.8% of the abdominal babies develop into lithopedion. There are only $ 330 known cases of lithopedion in the world. We describe a lithopedion that complicated as intestinal obstruction in a 71-year-old woman.Alexandre Sabino Sisnando's ORCID is https://orcid.org/0000-0002-2529-1479.

A Lithopedion – An Unusual Calcified Abdominal Pregnancy: A Case Report

“…pregnancies manifest nonspecific signs and symptoms, making diagnosis challenging. The most common complaints consist of persistent abdominal or suprapubic pain (100%), bloody vaginal discharge, gastrointestinal symptoms (70%), excruciating fetal movements (40%), and general malaise (40%) (2,7,8). The uterus will not be palpable on physical examination, and the fetal position may be persistently transverse or oblique.…”

“…For the formation of a lithopedion, an extrauterine, deceased fetus must remain for at least three months, remain sterile, and avoid being absorbed by the mother's immune system by forming a calcified shell around itself. Medically, it is neither diagnosed nor undiagnosed, but favorable conditions must exist for calcification (1,7,9). In 1880, German physician Friedrich Kuchenmeister identified three subgroups :…”

“…Lithopedion is frequently asymptomatic for a number of years. Patients seek medical attention primarily due to secondary symptoms such as abdominal pain, abdominal mass, or bladder or rectal compression symptoms (3,7).…”