Lithopedion diagnosed during infertility workup: a case report
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KeywordsEctopic Pregnancy Tubal Pregnancy Intrauterine Pregnancy Abdominal Pregnancy Calcify Growth
Lithopedion is an exceedingly rare entity in the modern era of medicine. Since the earliest case discovered in 1582 in France (Bondeson 1996), less than 300 cases of lithopedion have been reported (Irick et al. 1970; Frayer and Hibbert 1999; Spiritos et al. 1987). However in places with limited access to health care facilities and poor health awareness, lithopedion on rare occasions can baffle physicians with its appearance. Here we report a case of lithopedion in a young woman of 20 years resulting from ruptured ectopic pregnancy who attended our hospital for infertility.
Lithopedion is a greek word which means ‘stonechild’. This rare event occurs in 0.0054% of all gestations (Ede et al. 2011). Incidence of secondary abdominal pregnancy is 1 in 11,000 pregnancies. Lithopedion occurs in 1.5 to 1.8% of these cases (Costa et al. 1991; Frayer and Hibbert 1999).
Lithopedion describes an intraabdominal calcified dead fetus. A lithopedion can result from a primary abdominal pregnancy, or from a secondary abdominal implantation following tubal abortion or rupture of tubal or intrauterine pregnancy. It occurs when a sterile extrauterine fetus survives for more than 3 months in abdominal cavity and escapes medical discovery along with minimal and sluggish circulation inviting calcium deposition (Irick et al. 1970; Frayer and Hibbert 1999; Costa et al. 1991). Secondary abdominal implantation is one of rarest consequence of ruptured tubal pregnancy and the formation of lithopedion out of it is even rarer.
A rare entity though, lithopedion is not exinct and its diagnosis should not be missed in young infertile patients where period of retention may be small with minimal symptoms and vague obstetrical history. Appropriate history and keen suspicion in such cases from areas with limited access to healthcare facilities not only helps in diagnosis but can avert the dreadful complications it can accrue in course of time.
Written informed consent was obtained from the patient for the publication of this report and any accompanying images.
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