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Case Study of a 54 year old Jamaican Woman

At 54 years old, a Jamaican woman was applying for a position at the Sunnybrook Hospital. Before she was able to be employed, she had to undergo a pre-employment examination. This examination occurred on February 9, 1966 and it was during this time that an abdominal mass was found (Chase, 1968).

Medical History:

She has had a regular menses cycle which occurred every 28 days starting when she was 15 years old. In 1933 she gave birth to her first child. Her second pregnancy occurred a year later and again she had no problems or complications. At the age of 45 years old, she noticed that her abdomen was increasing in size and she was able to feel fetal movements (Chase, 1968). This woman did not believe that she was pregnant because she was still having vaginal bleeding, except it was irregular. During this time, her vaginal bleeding lasted several weeks and was quite profuse (Chase, 1968). After several months she was no longer able to feel fetal movements. The only problems that she still experienced were the abdominal pain and vaginal bleeding.

Diagnosis:

During her pre-employment examination a hard irregular mass was found in the lower abdomen. In order to determine what the mass was in this woman’s abdomen, an X-ray was taken (Chase, 1968). Figure 19 is the X-ray that was taken of the woman at the Sunnybrook Hospital and the following were the results reported from the X-ray. A fetus was present in a high position in the pelvis, which is an indication of an intra-abdominal pregnancy. The size indicates that it developed fairly close to term (Chase, 1968). From the X-ray it can be concluded that the fetus had been dead for a considerable period of time. There was also evidence of calcification of the soft tissues that were adjacent to the fetus and on the fetus itself (Chase, 1968).

Figure 19: X-ray of lithopedion taken at Sunnybrook Hospital

Treatment:

To remove the lithopedion, a laparotomy was performed and the partially calcified fetus was removed. Figure 20 shows the lithopedion after it was removed from the woman’s abdomen.

Figure 20: Calcified Lithopedion upon removal from woman's abdomen

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One response »

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