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Case Reports
. 2000 Apr-Jun;4(2):159-62.

Laparoscopic removal of a perforated intrauterine device from the perirectal fat

P D Silva  1 , K M Larson
Affiliations
Case Reports

Laparoscopic removal of a perforated intrauterine device from the perirectal fat

P D Silva et al. JSLS. 2000 Apr-Jun.

Abstract

Background: The intrauterine device (IUD) was a very common form of birth control in the United States. The most serious potential complication of IUD use is uterine perforation. Uterine perforation is common among women with "lost" IUDs and can cause severe morbidity and mortality and should be carefully managed. The recommended treatment is removal of the perforating IUD. This can usually be managed laparoscopically unless bowel perforation or other severe sepsis is present.

Methods: An intra-abdominal IUD was removed laparoscopically from the perirectal fat of a 49-year-old woman who had been diagnosed over 20 years earlier with an "expelled" IUD.

Conclusions: It is important that the possibility of uterine perforation be considered in anyone who has had a diagnosis of an expelled IUD without actual confirmation that the IUD is no longer present in the body. In any woman who presents with pelvic pain and a history of a "lost" IUD, the surgeon should have a high index of suspicion and obtain radiological studies. It may be advisable to question women about possible IUD use when they present with pelvic pain of unknown origin.

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Figures

Figure 1.
Figure 1.
Lippes Loop IUD buried in the perirectal fat and adhesions.
Figure 2.
Figure 2.
Partially dissected Lippes Loop.
Figure 3.
Figure 3.
Lippes Loop almost completely dissected free.
See this image and copyright information in PMC

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