A forgotten migrated intrauterine contraceptive device is not always innocent: a case report

Abstract

The incidence of transuterine perforation and migration of intrauterine contraceptive devices (IUCDs) into the abdominal cavity has been estimated at less than 0.1%. It has been suggested that intraperitoneal IUCD have low morbidity and may be left in situ. We report the first case of closed loop small bowel obstruction due to migration of a "Saf-T-Coil" IUCD into the abdominal cavity, where it became embedded in the omentum and ultimately, 31 years after deployment, coiled both arms around a loop of ileum. This late complication underlines the dangers of intra-abdominal foreign bodies, even when chemically and biologically inert.

Figure 1

(a) Abdominal X-ray. No free intra-abdominal air. Note IUCD in RIF. (b) CT scan of the abdomen.

Figure 2

(a) Intra-operative photograph showing migratory “Saf-T-Coil” IUCD, with each arm wrapped around a loop of mid ileum. (b) Operative note depicting configuration of “Saf-T-Coil” IUCD causing closed loop bowel obstruction. (c) Resected specimen-ischaemic loop of small bowel. (d) Obstructing “Saf-T-Coil” IUCD removed from abdomen.