Laparoscopic removal of migrated intrauterine device embedded in intestine

Migrated intra-uterine device to infra-umbilical skin: a rare case report

INTRODUCTION

IUDs are effective, reversible and safe methods of contraception. The mechanism of action of IUDs as a group is inducing endometrial atrophy, apoptosis, altering tubal motility; preventing sperm permeability, fertilization, and implantation. Complications of IUD include menstrual disturbance, pelvic pain, and increased risk of ectopic pregnancy with contraceptive failure, device expulsion, uterine perforation or transmural migration with misplacement of the device. Pregnancies and IUD migration are uncommon complications, occurring in 1 to 2 from 1,000 users. The clinical presentation of migrated IUDs depends on the final anatomic location at diagnosis. Migration can be asymptomatic and incidentally found while imaging for any other diagnosis or may have various acute clinical presentations.

CASE PRESENTATION

We present the case of a 38-years-old Ethiopian woman with unusual migration of IUD to the infra-umbilical skin. She had infra-umbilical skin discoloration associated with intermittent itching for two months duration. On physical examination, there was diffuse violaceous patch over the infra-umbilical skin measuring 7 centimeters on its longest dimension and visible foreign body (IUD) with tiny sinus tract formation. Visible stem of copper-containing IUD was grasped by ring forceps and removed with gentle traction without complication during or following extraction. Removal of misplaced IUD with completely non-invasive manner makes this case special in addition to the unique site of migration to the infra-umbilical skin.

CONCLUSION AND RECOMMENDATION

To our knowledge, this is what likely to be the first reported case of IUD migration to the infra-umbilical skin which bestows a new finding to the existing literatures. Despite rare occurrence, possible IUD complications should be included in the informed consent process before insertion. Self-examination of the strings and vigilant evaluation at regular checkup is recommended for early detection of migrated IUDs.

A Displaced Intrauterine Device Eroding Into the Sigmoid Colon

A 36-year-old female presented to the gynecology office eight weeks after the placement of a ParaGard intrauterine device (IUD). Upon gynecologic examination, the strings of the IUD were not found. Magnetic resonance imaging was performed which reported the IUD embedded in the sigmoid colon. Initial diagnostic laparoscopy was done without bowel preparation and revealed an IUD embedded within the sigmoid colon and mesocolon. Colonoscopy did not reveal any breach of the colonic lumen. A second diagnostic laparoscopy was planned with the robotic-assisted technique after bowel preparation. Intraoperative findings during the second operation identified the IUD embedded in the antimesenteric side of the sigmoid colon with surrounding scar tissue to the uterus. The IUD was sharply freed using robotic scissors and the resulting serosal defect was sutured in layers with buttress made of appendices epiploica. The patient recovered well and had an excellent outcome. Our article highlights the minimally invasive method of dealing with a displaced IUD. The use of the robotic technique was helpful in our case to achieve an excellent outcome.

Missing intrauterine device migrated to terminal ileum resembling adnexal mass: A case report

INTRODUCTION AND IMPORTANCE

Although IUD has become more popular in recent years, its migration through uterine perforation is a rare but serious complication.

PRESENTATION OF CASE

We present the case of a young otherwise healthy woman with a missing IUD that had penetrated terminal ileum.

CLINICAL DISCUSSION

The incidence of uterine perforation after IUD insertion has been reported 1.3 to 1.6 per 1000 insertions. Although a rare complication, it can cause serious problems requiring major surgery.

CONCLUSION

Uterine perforation and migration of IUD is a rare but serious complication that should be considered in all missing IUD threads.

Case Report: Iatrogenic trauma of the bladder due to long-term unidentified intrauterine device malposition inside the bladder with rectovesical fistula

According to reports, there are 1.9-3.6 incidences of IUD migration and uterine perforation for every 1000 IUD insertions. It is important to note that bladder perforation caused by a misplaced IUD is uncommon and is thought to happen most frequently during insertion. Here, we describe a patient who presented with symptoms related to the malposition of IUD inside the bladder. It is feasible to draw the conclusion that the cystoscopy technique should be taken into consideration as a suitable therapy option for such injuries in this organ. When a problem cannot be effectively treated by cystoscopy alone, laparotomy should be considered.

Removal of a Migrated Intrauterine Contraceptive Device Perforating the Terminal Ileum: A Case Report

We aim to present a rare case of a missing intrauterine contraceptive device (IUCD) that was found in the terminal ileum by laparoscopy and was managed initially by laparoscopy and then proceeded to laparotomy.

A 29-year-old female who had a copper IUCD inserted by a senior gynecologist presented to the clinic with pelvic pain and discomfort. She underwent laparoscopy for IUCD removal. Intraoperatively, the IUCD was discovered to be embedded in the terminal ileum, and therefore, laparoscopy was converted to an open laparotomy. The patient was readmitted multiple times because of abnormal fluid collection in the pelvic region, which was resolved finally by pigtail insertion.

This case sheds a light on the possibility of complications occurring in the medical field even if the practitioner is a senior gynecologist. Furthermore, missed IUCDs require thorough investigation and imaging to make an appropriate management plan to avoid serious complications.

Incomplete Removal of an Intrauterine Device Perforating the Sigmoid Colon

Intrauterine devices (IUDs) are widely used for contraception in South Korea. However, several complications of IUDs have been reported, including inflammation, obstruction, perforation, and fistula. IUD perforation is the rarest of these complications but is also severe. Migrated IUDs can be retrieved through endoscopy, laparoscopy, or laparotomy. Presented below is an atypical case of an IUD perforating the sigmoid colon, which could not be removed endoscopically, and was subsequently incompletely removed through laparoscopic surgery. The present case underlines the importance of appropriate diagnosis and treatment approach in the management of IUD perforation.

A 47-Year-Old Woman with Gastric Transmigration of an Intrauterine Contraceptive Device Managed by Laparoscopic Wedge Gastric Resection

Patient: Female, 47-year-old

Final Diagnosis: Perforated intrauterine contraceptive device

Symptoms: Asymptomatic

Medication:—

Clinical Procedure: —

Specialty: Surgery

Bladder-embedded ectopic intrauterine device with calculus

The present study aimed to analyze the data of embedded intrauterine device (IUD) in the bladder wall with the additional presence of calculus. This case series study included 11 female patients with partially or completely embedded IUD in the bladder wall. Their median age was 34 (range, 32-39) years. The median duration of IUD placement was 36 (range, 24-60) months. The median duration of symptoms was 9 (range, 3-12) months. Six patients underwent laparoscopy: the operation duration was 129 (range, 114-162) min, blood loss was 15 (range, 10-25) mL, the hospital stay was 4 (range, 4-4.5) days, the visual analog scale (VAS) for pain at 6 h after surgery was 3 (range, 2-6), and the time to removal of the urethral catheter was 7 (range, 7-8) days. Five patients underwent open surgery: the operation duration was 126 (range, 96-192) min, blood loss was 30 (range, 20-50) mL, the hospital stay was 7 (range, 7-15) days, the VAS was 6 (range, 4-9) at 6 h after surgery, and the time to removal of the urethral catheter was 9 (range, 8-17) days. The IUD and bladder stones were successfully removed in all 11 (100%) patients.

Intrauterine Contraceptive Device Perforating the Cecum, a Pregnancy Complication?

Intrauterine contraceptive device (IUCD) is a widely used method of contraception worldwide. Displacement of the IUCD extrauterine, by perforating the uterus and migration, is a serious complication following its insertion. We reported an extremely rare case of a 24-year-old female patient found to have a copper T 380A IUCD displaced from its normal site to be embedded into the cecum, suggested to have occurred during pregnancy, and being successfully removed laparoscopically.

The Management of a patient with a fragmented intrauterine device embedded within the cervical canal

A 28-year-old woman presented with a malpositioned intrauterine device (IUD) that was fragmented and significantly entrenched within the cervical canal and myometrium. IUD malposition with concomitant device fragmentation and embedded segments, albeit rare, should be a consideration given the device's prevalence.

Clinical characteristic and intraoperative findings of uterine perforation patients in using of intrauterine devices (IUDs)

Background

Intrauterine devices (IUDs) are the most popular form of contraception used worldwide; however, IUD is not risk-free. IUD migrations, especially uterine perforations, were frequently occurred in patients. The aim of this study was to investigate the clinical characteristics and intraoperative findings in patients with migrated IUDs.

Results

29 cases of uterine perforation associated with migrated IUDs and 69 control patients were followed between January 2008 to March 2015. Patients who used IUDs within first 6 months from the last delivery experienced a characteristically high rate of the perforation of the uterine wall. A significantly larger number of IUD insertion associated with uterine perforation were performed in rural hospitals or operated at a lower level health care system. There was no clear difference in the age and presented symptoms in patients between two groups. Majority of contraceptive intrauterine devices was the copper-releasing IUDs. Furthermore, patients who used V-shaped IUD showed significantly higher incidence of pelvic adhesions when compared with the users of O-shaped IUDs.

Conclusions

Unique clinical characteristics of IUD migration were identified in patients with uterine perforation. Hysteroscopy and/or laparoscopy were the effective approaches to remove the migrated IUDs. Improving operating skills is required at the lower level of health care system.

Laparoscopic removal of migrated intrauterine device

Intrauterine device (IUD) is a popular long-acting reversible contraceptive device with an estimated rate of use of about 5.3%. It is highly effective but not without complications, one of which is uterine perforation. The patient was a 32-year-old female who presented with nausea, vomiting and right upper quadrant abdominal pain that was tender on palpation. CT scan was performed and they found signs of acute calculous cholecystitis with incidental finding of a migrated IUD in the left lateral mid-abdomen within the peritoneal cavity. She underwent a laparoscopic cholecystectomy followed by a successful IUD retrieval. Most uterine perforations occur at the time of insertion; however, partial perforation with subsequent delayed complete perforation may also occur. This case emphasises the importance of a full workup for a missing IUD and that, if incidentally found, IUDs can be removed safely laparoscopically in conjunction with another procedure.