Lithopaedon Presenting as Intestinal Obstruction with a Previous Co-Existing Intra-Uterine Pregnancy

Abstract

This is a case report of a 25 year old lady Para 4 + 0 gravida 5, who was referred to Kisii level 5 hospital from a district hospital with a diagnosis of intestinal obstruction and a four year history of an intra-abdominal mass. A year prior to the admission she conceived and delivered vaginally at home but the baby died a few hours after the delivery. On examination on admission there was a solid mass in the right upper quadrant. Ultrasound imaging showed a poor echo-calcified mass suggestive of a colonic metastatic mass and an erect abdominal x ray revealed foetal bones within the abdominal cavity. At laparatomy a lithopedion with a normal uterus was found. The presence of a lithopedion and a normal intra-uterine pregnancy followed by spontaneous vertex delivery has not been reported in Kenya. Patients with lithopaedon can present with intestinal obstruction as a complication but the presence of a co-existing pregnancy is rare.