CC BY 4.0 · Rev Bras Ginecol Obstet 2019; 41(02): 129-132
DOI: 10.1055/s-0038-1676060
Case Report
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

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

Litopedia causando obstrução intestinal em idosa de 71 anos: relato de caso

Francisco Eliomar Gomes de Oliveira
1   Board of Directors, Hospital de Aeronáutica de Recife, Força Aérea Brasileira, Jaboatão dos Guararapes, PE, Brazil
,
Sandra Regina Alves dos Santos
2   Division of Medicine, Hospital Central de Aeronáutica, Força Aérea Brasileira, Rio de Janeiro, RJ, Brazil
,
Bruno Gomes Duarte
2   Division of Medicine, Hospital Central de Aeronáutica, Força Aérea Brasileira, Rio de Janeiro, RJ, Brazil
,
3   Division of Medicine, Fortaleza Health Squadron, Força Aérea Brasileira, Fortaleza, CE, Brazil
› Institutsangaben
Weitere Informationen

Publikationsverlauf

22. Juli 2018

01. Oktober 2018

Publikationsdatum:
20. Februar 2019 (online)

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.

Resumo

A gravidez ectópica é a principal causa de morte materna no primeiro trimestre, e ocorre em 1 a 2% das gestações. Mais de 90% ocorrem nas tubas uterinas. Gravidez abdominal refere-se à gravidez ectópica implantada na cavidade peritoneal, externamente ao útero e às tubas uterinas. A incidência estimada é de 1 por 10 mil nascimentos e 1,4% das gravidezes ectópicas. A litopedia é um tipo raro de gravidez ectópica, e ocorre quando o feto de uma gravidez abdominal não reconhecida morre e se calcifica. O “bebê de pedra” resultante pode não ser detectado por décadas, e pode causar complicações futuras. A litopedia é um evento muito raro que ocorre em 0,0054% de todas as gestações. Cerca de 1,5 a 1,8% dos bebês abdominais se tornam litopédios. Existem somente cerca de 330 casos conhecidos de litopedia no mundo. Descrevemos uma litopedia que se agravou, tornando-se uma obstrução intestinal, em uma idosa de 71 anos.

 
  • References

  • 1 Centers for Disease Control and Prevention (CDC). Ectopic pregnancy--United States, 1990-1992. MMWR Morb Mortal Wkly Rep 1995; 44 (03) 46-48
  • 2 Bouyer J, Coste J, Fernandez H, Pouly JL, Job-Spira N. Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Hum Reprod 2002; 17 (12) 3224-3230
  • 3 Atrash HK, Friede A, Hogue CJ. Abdominal pregnancy in the United States: frequency and maternal mortality. Obstet Gynecol 1987; 69 (3 Pt 1): 333-337
  • 4 Binder DS. Thirteen-week abdominal pregnancy after hysterectomy. J Emerg Med 2003; 25 (02) 159-161
  • 5 Fader AN, Mansuria S, Guido RS, Wiesenfeld HC. A 14-week abdominal pregnancy after total abdominal hysterectomy. Obstet Gynecol 2007; 109 (2 Pt2): 519-521
  • 6 Odom SR, Gemer M, Muyco AP. Lithopedion presenting as intra-abdominal abscess and fecal fistula: report of a case and review of the literature. Am Surg 2006; 72 (01) 77-78
  • 7 Dover RW, Powell MC. Management of a primary abdominal pregnancy. Am J Obstet Gynecol 1995; 172 (05) 1603-1604
  • 8 Varma R, Mascarenhas L, James D. Successful outcome of advanced abdominal pregnancy with exclusive omental insertion. Ultrasound Obstet Gynecol 2003; 21 (02) 192-194
  • 9 Onan MA, Turp AB, Saltik A, Akyurek N, Taskiran C, Himmetoglu O. Primary omental pregnancy: case report. Hum Reprod 2005; 20 (03) 807-809
  • 10 Ludwig M, Kaisi M, Bauer O, Diedrich K. The forgotten child--a case of heterotopic, intra-abdominal and intrauterine pregnancy carried to term. Hum Reprod 1999; 14 (05) 1372-1374
  • 11 Shippey SH, Bhoola SM, Royek AB, Long ME. Diagnosis and management of hepatic ectopic pregnancy. Obstet Gynecol 2007; 109 (2 Pt2): 544-546
  • 12 Phupong V, Tekasakul P, Kankaew K. Broad ligament twin pregnancy. A case report. J Reprod Med 2001; 46 (02) 144-146
  • 13 Tsudo T, Harada T, Yoshioka H, Terakawa N. Laparoscopic management of early primary abdominal pregnancy. Obstet Gynecol 1997; 90 (4 Pt 2): 687-688
  • 14 Rahman MS, Al-Suleiman SA, Rahman J, Al-Sibai MH. Advanced abdominal pregnancy--observations in 10 cases. Obstet Gynecol 1982; 59 (03) 366-372
  • 15 Cormio G, Santamato S, Vimercati A, Selvaggi L. Primary splenic pregnancy. A case report. J Reprod Med 2003; 48 (06) 479-481
  • 16 Lamina MA, Akinyemi BO, Fakoya TA, Shorunmu TO, Oladapo OT. Abdominal pregnancy: a cause of failed induction of labour. Niger J Med 2005; 14 (02) 213-217
  • 17 Kitade M, Takeuchi H, Kikuchi I, Shimanuki H, Kumakiri J, Kinoshita K. A case of simultaneous tubal-splenic pregnancy after assisted reproductive technology. Fertil Steril 2005; 83 (04) 1042
  • 18 Jazayeri A, Davis TA, Contreras DN. Diagnosis and management of abdominal pregnancy. A case report. J Reprod Med 2002; 47 (12) 1047-1049
  • 19 Rahaman J, Berkowitz R, Mitty H, Gaddipati S, Brown B, Nezhat F. Minimally invasive management of an advanced abdominal pregnancy. Obstet Gynecol 2004; 103 (5 Pt 2): 1064-1068
  • 20 Lockhat F, Corr P, Ramphal S, Moodley J. The value of magnetic resonance imaging in the diagnosis and management of extra-uterine abdominal pregnancy. Clin Radiol 2006; 61 (03) 264-269
  • 21 Beddock R, Naepels P, Gondry C. , et al. [Diagnosis and current concepts of management of advanced abdominal pregnancy]. Gynécol Obstét Fertil 2004; 32 (01) 55-61
  • 22 Stevens CA. Malformations and deformations in abdominal pregnancy. Am J Med Genet 1993; 47 (08) 1189-1195
  • 23 Gedam BS, Shah Y, Deshmukh S, Bansod PY. Skeletal remains of mummified foetus for 36 years in mother's abdomen. Int J Surg Case Rep 2015; 7C: 109-111