Department of Internal Medicine, SUNY Upstate Medical University, 750 East Adams St, Syracuse, NY, 13210, USA.
Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA, USA.
BMC Womens Health. 2023 Mar 7;23(1):89. doi: 10.1186/s12905-023-02244-z.
Lithopedion is a term that refers to a fetus that has calcified or changed to bone. The calcification may involve the fetus, membranes, placenta, or any combination of these structures. It is an extremely rare complication of pregnancy and can remain asymptomatic or present with gastrointestinal and/or genitourinary symptoms.
A 50-year-old Congolese refugee with a nine-year history of retained fetus after a fetal demise was resettled to the United States (U.S.). She had chronic symptoms of abdominal pain and discomfort, dyspepsia, and gurgling sensation after eating. She experienced stigmatization from healthcare professionals in Tanzania at the time of the fetal demise and subsequently avoided healthcare interaction whenever possible. Upon arrival to the U.S., evaluation of her abdominal mass included abdominopelvic imaging which confirmed the diagnosis of lithopedion. She was referred to gynecologic oncology for surgical consultation given intermittent bowel obstruction from underlying abdominal mass. However, she declined intervention due to fear of surgery and elected for symptom monitoring. Unfortunately, she passed away due to severe malnutrition in the context of recurrent bowel obstruction due to the lithopedion and continued fear of seeking medical care.
This case demonstrated a rare medical phenomenon and the impact of medical distrust, poor health awareness, and limited access to healthcare among populations most likely to be affected by a lithopedion. This case highlighted the need for a community care model to bridge the gap between the healthcare team and newly resettled refugees.
石胎是一个术语，指的是已经钙化或变成骨头的胎儿。钙化可能涉及胎儿、胎膜、胎盘或这些结构的任何组合。它是妊娠的一种极其罕见的并发症，可以无症状存在，也可以表现为胃肠道和/或泌尿生殖系统症状。
一位 50 岁的刚果难民，在胎儿死亡后有 9 年的胎儿残留病史，被重新安置到美国。她长期有腹痛和不适、消化不良和进食后肠鸣音的症状。她在坦桑尼亚胎儿死亡时受到医护人员的歧视，此后尽可能避免与医护人员互动。抵达美国后，对她腹部肿块的评估包括腹部和骨盆成像，这证实了石胎的诊断。由于潜在的腹部肿块间歇性肠梗阻，她被转介到妇科肿瘤学进行手术咨询。然而，由于对手术的恐惧，她拒绝了干预，并选择了症状监测。不幸的是，由于反复肠梗阻导致的石胎和持续害怕寻求医疗护理而严重营养不良，她去世了。
这个病例展示了一种罕见的医学现象，以及对医疗的不信任、健康意识差和获得医疗保健机会有限对最有可能受到石胎影响的人群的影响。这个病例强调了需要一种社区护理模式来弥合医疗团队和新重新安置的难民之间的差距。
