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.
方法:一名50岁的刚果难民在胎儿死亡后保留了9年的胎儿,被重新安置到美国(美国)。她有腹痛和不适的慢性症状,消化不良,进食后有咯咯的感觉。在胎儿死亡时,她经历了坦桑尼亚医疗保健专业人员的污名化,随后尽可能避免了医疗保健互动。抵达美国后,对她的腹部肿块的评估包括腹骨盆成像,证实了结石的诊断。由于腹部肿块引起间歇性肠梗阻,她被转诊到妇科肿瘤科进行手术咨询。然而,她因害怕手术而拒绝干预,并选择进行症状监测.不幸的是,她因严重营养不良而去世,原因是由于石斑病引起的肠梗阻复发,并继续担心寻求医疗护理。
结论:这个案例证明了一种罕见的医学现象和医学不信任的影响,健康意识差,以及最有可能受到Lithopedion影响的人群获得医疗保健的机会有限。此案突显了社区护理模式的必要性,以弥合医疗团队与新安置的难民之间的差距。