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An unusual cause of intra-abdominal calcification: A lithopedion

We report a case of a 77-year-old female who was admitted to the emergency department complaining of diffuse abdominal pain for five days, associated with nausea, vomiting and constipation. Physical examination disclosed a large incarcerated umbilical hernia, which was readily apparent on supine abd...

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Autores principales: Ramos-Andrade, Daniel, Ruivo, Catarina, Portilha, M. Antónia, Brito, Jorge B., Caseiro-Alves, Filipe, Curvo-Semedo, Luís
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750627/
https://www.ncbi.nlm.nih.gov/pubmed/26937428
http://dx.doi.org/10.1016/j.ejro.2014.09.004
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author Ramos-Andrade, Daniel
Ruivo, Catarina
Portilha, M. Antónia
Brito, Jorge B.
Caseiro-Alves, Filipe
Curvo-Semedo, Luís
author_facet Ramos-Andrade, Daniel
Ruivo, Catarina
Portilha, M. Antónia
Brito, Jorge B.
Caseiro-Alves, Filipe
Curvo-Semedo, Luís
author_sort Ramos-Andrade, Daniel
collection PubMed
description We report a case of a 77-year-old female who was admitted to the emergency department complaining of diffuse abdominal pain for five days, associated with nausea, vomiting and constipation. Physical examination disclosed a large incarcerated umbilical hernia, which was readily apparent on supine abdominal plain films. These also showed a calcified heterogeneous mass in the mid-abdominal region, which was further characterized by CT as a lithopedion (calcified ectopic pregnancy). This is one of the few cases studied on a MDCT equipment, and it clearly enhances the post-processing abilities of this imaging method which allows diagnostic high-quality MIP images. Lithopedion is a rare entity, with less than 300 cases previously described in the medical literature. However, many reported cases corresponded to cases of skeletonization or collections of fetal bone fragments discovered encysted in the pelvic region at surgery or autopsy. It is thus estimated that true lithopedion is a much rarer entity. The diagnosis may be reached by a suggestive clinical history and a palpable mass on physical examination, while the value of modern cross-sectional techniques is still virtually unknown. Ultrasonography may depict an empty uterine cavity and a calcified abdominal mass of non-specific characteristics, and computed tomography or magnetic resonance imaging are able to reach a conclusive diagnosis and may additionally define the involvement of adjacent structures. The differential diagnosis includes other calcified pathologic situations, including ovarian tumors, uterine fibroids, urinary tract neoplasms, inflammatory masses or epiploic calcifications.
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spelling pubmed-47506272016-03-02 An unusual cause of intra-abdominal calcification: A lithopedion Ramos-Andrade, Daniel Ruivo, Catarina Portilha, M. Antónia Brito, Jorge B. Caseiro-Alves, Filipe Curvo-Semedo, Luís Eur J Radiol Open Review We report a case of a 77-year-old female who was admitted to the emergency department complaining of diffuse abdominal pain for five days, associated with nausea, vomiting and constipation. Physical examination disclosed a large incarcerated umbilical hernia, which was readily apparent on supine abdominal plain films. These also showed a calcified heterogeneous mass in the mid-abdominal region, which was further characterized by CT as a lithopedion (calcified ectopic pregnancy). This is one of the few cases studied on a MDCT equipment, and it clearly enhances the post-processing abilities of this imaging method which allows diagnostic high-quality MIP images. Lithopedion is a rare entity, with less than 300 cases previously described in the medical literature. However, many reported cases corresponded to cases of skeletonization or collections of fetal bone fragments discovered encysted in the pelvic region at surgery or autopsy. It is thus estimated that true lithopedion is a much rarer entity. The diagnosis may be reached by a suggestive clinical history and a palpable mass on physical examination, while the value of modern cross-sectional techniques is still virtually unknown. Ultrasonography may depict an empty uterine cavity and a calcified abdominal mass of non-specific characteristics, and computed tomography or magnetic resonance imaging are able to reach a conclusive diagnosis and may additionally define the involvement of adjacent structures. The differential diagnosis includes other calcified pathologic situations, including ovarian tumors, uterine fibroids, urinary tract neoplasms, inflammatory masses or epiploic calcifications. Elsevier 2014-10-16 /pmc/articles/PMC4750627/ /pubmed/26937428 http://dx.doi.org/10.1016/j.ejro.2014.09.004 Text en © 2014 The Authors http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
spellingShingle Review
Ramos-Andrade, Daniel
Ruivo, Catarina
Portilha, M. Antónia
Brito, Jorge B.
Caseiro-Alves, Filipe
Curvo-Semedo, Luís
An unusual cause of intra-abdominal calcification: A lithopedion
title An unusual cause of intra-abdominal calcification: A lithopedion
title_full An unusual cause of intra-abdominal calcification: A lithopedion
title_fullStr An unusual cause of intra-abdominal calcification: A lithopedion
title_full_unstemmed An unusual cause of intra-abdominal calcification: A lithopedion
title_short An unusual cause of intra-abdominal calcification: A lithopedion
title_sort unusual cause of intra-abdominal calcification: a lithopedion
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750627/
https://www.ncbi.nlm.nih.gov/pubmed/26937428
http://dx.doi.org/10.1016/j.ejro.2014.09.004
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