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Review
. 2022 Mar 10:9:817029.
doi: 10.3389/fmed.2022.817029. eCollection 2022.

Is It a "Colon Perforation"? A Case Report and Review of the Literature

Shuangshuang Lu  1   2 , Xinyu Yao  2 , Jun Shi  2 , Jian Huang  2 , Shaohua Zhuang  2 , Junfang Ma  2 , Yan Liu  2 , Wei Zhang  2 , Lifei Yu  2 , Ping Zhu  2 , Qiuwei Zhu  2 , Ruxia Shi  2 , Hong Zheng  2 , Dong Shao  2 , Yuyan Pan  2 , Shizhen Bao  2 , Li Qin  2 , Lijie Huang  2 , Wenjia Liu  1   2 , Jin Huang  1   2
Affiliations
Review

Is It a "Colon Perforation"? A Case Report and Review of the Literature

Shuangshuang Lu et al. Front Med (Lausanne). .

Abstract

Background: Intrauterine devices (IUDs) are commonly used as a contraceptive method. IUD migration and colon perforation are rare but serious complications occurring sometimes years after insertion.

Case: A 42-year-old woman with complaints of slight abdominal pain underwent a colonoscopy. Colonoscopy showed that a "nail" had penetrated the ascending colon wall and that an arm of the "nail" was embedded in the colon wall. We did not remove the "nail" rashly under colonoscopy. Considering the safety and effectiveness of the patient's operation, we were able to remove the "nail" easily by performing laparoscopic-endoscopic cooperative surgery (LECS) combined with hysteroscopy at the same time.

Conclusion: We report a case of successful removal of a colonic perforation device by colonoscopy, laparoscopy, and hysteroscopy, which is the first method used.

Keywords: colon perforation; hysteroscopy; intrauterine devices; laparoscopic-endoscopic cooperative surgery; migration.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Colonoscopy and abdominal CT findings. Colonoscopy showed a foreign body similar to a nail in the ascending colon, and a local ulcer was formed (A). CT showed a foreign body through the wall of the colon (B,C).
Figure 2
Figure 2
Laparoscopic-endoscopic cooperative surgery and no obvious abnormality were found during hysteroscopy. (A) The IUD was removed under laparoscope. (B) The IUD embedded in the colon wall showed a white protuberance outside the cavity (arrow). (C) Haemoclips at the wound site to prevent perforation of the colon. (D) The weak intestinal wall was sutured to prevent perforation. (E) Localized erosion at the posterior wall of the uterus and dense adhesions between the uterus and colon. (F) Bipolar coagulation to stop bleeding. (G) Morphology of uterine cavity. (H) Opening of right fallopian tube. (I) Opening of left fallopian tube.
Figure 3
Figure 3
The IUD was removed successfully.
See this image and copyright information in PMC

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