Abdominal pregnancy in a 67-year-old woman undetected for 37 years - A case report

BACKGROUND: Abdominal pregnancy is an exceedingly rare occurrence, but even more unusual is prolonged retention of an advanced abdominal pregnancy wit h lithopedion formation. We present the case of prolonged retention of an a dvanced abdominal pregnancy in an elderly women. CASE: A 67-year-old, white woman presented to the emergency department with abdominal pain. Art acute abdominal series revealed It fetal skeleton exte nding from the patient's pelvis to her lower costal margins. Pelvic examina tion revealed a normal postmenopausal uterus, and human chorionic gonadotro pin was negative. On further questioning the patient reported that she had become pregnant 37 years earlier and was diagnosed Its having a "missed" pr egnancy. She refused intervention at that tints but suffered no untoward co nsequences. She reported having had later a healthy intrauterine pregnancy, delivered vaginally at term. No attempt was made to remove the prior misse d abdominal pregnancy. The acute pain episode resolved, and there was no su rgical intervention. CONCLUSION: Abdominal pregnancies can have a complex course, and management decisions can be difficult. This case presents an unusual outcome of an ad vanced abdominal pregnancy and illustrates a unique approach to management.