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Case Reports
. 2021 Jul 8:68:102547.
doi: 10.1016/j.amsu.2021.102547. eCollection 2021 Aug.

Intraperitoneal migration of an intrauterine device (IUD): A case report

Hicham Benaguida  1 , Hamza Kiram  1 , Ely Cheikh Telmoudi  1 , Btissam Ouafidi  1 , Mustapha Benhessou  2 , Mohamed Ennachit  2 , Mohamed Elkarroumi  3
Affiliations
Case Reports

Intraperitoneal migration of an intrauterine device (IUD): A case report

Hicham Benaguida et al. Ann Med Surg (Lond). .

Abstract

Introduction: The IUD is one of the most widely used reversible, long-term contraceptive methods in the world. About 80% of IUDs are found in the peritoneal cavity after uterine perforation.

Case report: A 27-year-old female patient presented with chronic pelvic pain with minimal metrorrhagia for 8 months on IUD. On examination, there was no IUD thread. Pelvic ultrasound showed a hypoechoic, heterogeneous, poorly limited formation measuring 3 × 2.68 cm. Abdominal-pelvic CT scan showed hyperdense supravesical material surrounded by a hypo-dense, well-limited collection measuring 26 × 25 mm. Laparoscopy showed an anterior peritoneal collection above the bladder containing the IUD, a uterus, adnexa, and a bladder without abnormality. The IUD was removed after incision of the collection and aspiration of the pus.

Discussion: The IUD is one of the most widely used long-term reversible contraceptive methods in the world. But like any foreign body, it can present complications, notably migration after uterine perforation, which remains rare, and even rarer peritoneal localization. The clinical diagnosis is not always obvious, and additional examinations are necessary to locate the device, including endovaginal ultrasound, a CT scan or magnetic resonance imaging.WHO recommends surgical removal of the migrated IUD by minimally invasive methods, including hysteroscopy, cystoscopy, colonoscopy, or laparoscopy, depending on the location of the IUD.

Conclusion: IUDs are effective contraceptive measures, and the majority of patients with uterine perforation by IUD migration are asymptomatic. Diagnosis is based on a thorough gynecologic analysis and appropriate radiologic imaging.

Keywords: Intraperitoneal; Intrauterine device; Laparoscopy; Migration.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Suprapubic pelvic ultrasound: Appearance suggestive of a pre-vesical migration of an IUD with a collection around it.
Fig. 2
Fig. 2
Abdomino-pelvic CT showed on a sagittal section and an axial section: an anteverted uterus with an IUD above the bladder associated with a collection came into contact with the anterior wall of the bladder with conservation of the separation line.
Fig. 3
Fig. 3
Exploration by laparoscopy.(a). A supra-vesical peritoneal collection, (b). Extraction of an IUD migrated intraperitoneally after incision of the collection.
See this image and copyright information in PMC

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