Sigmoid penetration by an intrauterine device

Intrauterine device migration into the lumen of large bowel: A case report

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Colon perforation caused by Intrauterine Device is a rare but severe complication.

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No similar cases were found after reviewing articles in over a 10-year period.

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It is still recommended to remove any free foreign body in abdominal cavity.

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For intraabdominal penetrations, the laparoscopic approach is an appropriate method.

Introduction

Colon perforation caused by the intrauterine device (IUD) migration is rare, but severe complication that can occur years after the insertion. Depending on the location of the injured intestine, the different methods for extracting migrated IUD raging from colonoscopy to laparotomy can be chosen.

Case presentation

A 41-year-old female presented with the discomfort in the epigastric area went to the outpatient clinic. A doctor performed gastroscopy and found a polyp. During a colonoscopy, we found a small solid object protruding through the intestinal wall. CT scan showed IUD like “T” shape foreign body, which longest part was protruding a wall of the colon. After these CT findings, the patient informed us that she had IUD inserted almost ten years ago. We found the device with the laparoscopic approach. IUD was removed and the intestinal damage was repaired during the mini-laparotomy.

Conclusions

Perforation of IUD can be asymptomatic, although sometimes it can cause short-term or long-term symptoms. Penetrated IUDs should be removed whenever identified. For intra-abdominal penetrations, the laparoscopic or mini-laparotomy approach is a safe and appropriate method.

A new endoscopic method of retrieval of a migrated and transmurally embedded intrauterine contraceptive device in the rectum

A 45-year-old lady presented with left lower quadrant abdominal pain and hematochezia of 1 month duration. She had Copper-T, an intrauterine contraceptive device (IUCD) inserted in the immediate post-partum period 25 years ago elsewhere and was lost to follow up. CT abdomen done 2 weeks earlier before reporting to us revealed a migrated and translocated IUCD embedded in the right lateral wall of the rectum. On colonoscopy, an area of friable mucosal nodule was noticed in the right lateral wall 10 cm from the anal verge but the IUCD was not visible intraluminally. Fluoroscopy showed the horizontal limb lying in close approximation with the rectal wall and the vertical limb of the IUCD embedded at the site of mucosal nodule in the rectum. After a careful endoscopic mucosotomy, the vertical limb was exposed and the Copper-T in its entirety was retrieved using a polypectomy snare. The mucosal defect was closed with hemoclips. She became asymptomatic after the procedure.

Laparoscopic removal of an intrauterine device from the sigmoid colon

Uterine wall perforation which is commonly seen through the posterior wall of the uterus is the most serious complication of an intrauterine device (IUD). We present a case of laparoscopic removal of an IUD from the sigmoid colon in a 31-years-old female who was admitted to hospital with a history of pelvic pain and abnormal vaginal bleeding for one month. The dislocated IUD was removed from the sigmoid colon of laparoscopic intervention without any complications.

In conclusion, the treatment modality for the removal of a dislocated IUD is possible by laparoscopic surgery in selected patients where the dislocated IUD is accessible.

Laparoscopic removal of a copper intrauterine device from the sigmoid colon

Removal of a migrated intrauterine device by using minimally invasive procedures is indicated even in select asymptomatic patients.

IUD translocation to the sigmoid colon after uterine perforation is a rare but serious event. Removal of the IUD in such a situation has been recommended because of the risk of complication, such as fistula formation and colonic perforation. We present the case of a 43-year-old female with a copper T380A IUD embedded in the sigmoid colon, which was removed with minimally invasive techniques.