Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Mar 4:8:81.
doi: 10.1186/1752-1947-8-81.

Sigmoid colocolic fistula caused by intrauterine device migration: a case report

Amila Weerasekera  1 , Pravin Wijesinghe, Nilhan Nugaduwa
Affiliations

Sigmoid colocolic fistula caused by intrauterine device migration: a case report

Amila Weerasekera et al. J Med Case Rep. .

Abstract

Introduction: The intrauterine device is a form of contraception with a long duration of action and few systemic side effects. Migration into the abdominal cavity may occur early or years after insertion giving rise to bowel obstruction, perforation, ischemia, mesenteric injury, strictures or fistulae. Colocolic fistula formation is a rare but serious complication of intrauterine device migration, which may lead to difficulties in diagnosis and device retrieval.

Case presentation: We report the case of a 29-year-old Sri Lankan woman who became pregnant 5 years after intrauterine device insertion. The device could not be located during pregnancy. She was asymptomatic and defaulted follow up during the antenatal period. She had an uncomplicated vaginal delivery. A subsequent laparotomy for device retrieval failed due to technical difficulties. A repeat laparotomy identified a sigmoid colocolic fistula with adhesions to the fallopian tube. The device was removed and colonic defects primarily closed following which the patient made an uneventful recovery.

Conclusions: All translocated intrauterine devices should be removed regardless of type and location. This case illustrates that they may cause complex bowel lesions leading to serious technical difficulties during retrieval. With the increasing use of minimally invasive approaches for intrauterine device retrieval, a low threshold for open surgery in complicated cases is advocated.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Anteroposterior X-ray of pelvis showing the intrauterine device (arrowed).
Figure 2
Figure 2
The sigmoid colon was delivered through a transverse incision. The intrauterine device was removed from the proximal and distal sigmoid. Part of the stem is seen within the fibrous tract extending from the uterus to the colon.
Figure 3
Figure 3
Removal of the intrauterine device colon left two openings in the proximal and distal sigmoid colon. The edges were trimmed and both defects primarily sutured (arrowed).
See this image and copyright information in PMC

References

    1. Arslan A, Kanat-Pektas M, Yesilyurt H, Bilge U. Colon penetration by a copper intrauterine device: a case report with literature review. Arch Gynecol Obstet. 2009;279:395–397. doi: 10.1007/s00404-008-0716-2. - DOI - PubMed
    1. Prabhu JK, Rani R, Nayak NK, Natarajan P. Migration of intrauterine contraceptive device into sigmoid colon. J ObstetGynaecol. 2010;30:526–527. - PubMed
    1. Tosun M, Celik H, Yavuz E, Cetinkaya MB. Intravesical migration of an intrauterine device detected in a pregnant woman. Can Urol Assoc. 2010;4:E141–E143. - PMC - PubMed
    1. Andersson K, Ryde-Blomqvist E, Lindell K, Odlind V, Milsom I. Perforations with intrauterine devices. Report from a Swedish survey. Contraception. 1998;57:251–255. doi: 10.1016/S0010-7824(98)00029-8. - DOI - PubMed
    1. Gill RS, Mok D, Hudson M, Shi X, Birch DW, Karmali S. Laparoscopic removal of an intra-abdominal intrauterine device: case and systematic review. Contraception. 2012;85:15–18. doi: 10.1016/j.contraception.2011.04.015. - DOI - PubMed

LinkOut - more resources