Stone baby
by Dr. Andrew Folley
History
The patient is a 37-year-old Zairian female who lives in a village of
Malongo at the headwaters of the Congo River. She presented with a
relatively asymptomatic large abdominal mass. Examination revealed a
distended abdomen with a very irregularly contoured mass present
consistent
with a large fibroid uterus 28-32 weeks size. The patient was having
fairly
regular periods. She has had eight previous pregnancies with five living
children. Recommendation made for exploratory laparotomy through a midline
incision with a working diagnosis of uterine leiomyomata.
Exploration through the midline incision revealed no free fluid present in
the abdomen. The uterus and ovaries felt fairly normal to palpation. A
large
calcified spherical mass was delivered through the incision, enveloped
with
omental adhesions. At this point diagnosis was thought be possibly some
type
of splenic or mesenteric tumor. The diagnosis was finally made when a
shoulder was delivered along with this mass. Finally, after the adhesions
were removed, a four pound calcified fetus was removed. This appeared to
be
approximately a 32-week intra-abdominal pregnancy which had DIED AND CALCIFIED
In further questioning the patient, she stated that she had been pregnant
about three years ago and everything seemed to be going fine, but "the
baby
never came out."
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