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

Abstract

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.

Keywords: Colon; Intrauterine device; Laparoscopy; Migration; Missing IUD; Perforation.

Fig. 1

Object protruding through the intestinal wall.

Fig. 2

Attempt to pull out object with endoscopic loop.

Fig. 3

CT with a foreign body.

Fig. 4

A foreign body during laparoscopy.