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Case Reports
. 2023 Nov 6:16:719-723.
doi: 10.2147/IMCRJ.S425424. eCollection 2023.

Uterocolon Fistula Formation in 50 Year Old Patient with History of 16 Years Intrauterine Device Use: A Case Report

Adiguna Wibawa Gurnita  1 , Eppy Darmadi Achmad  1
Affiliations
Case Reports

Uterocolon Fistula Formation in 50 Year Old Patient with History of 16 Years Intrauterine Device Use: A Case Report

Adiguna Wibawa Gurnita et al. Int Med Case Rep J. .

Abstract

Introduction: Uterocolon fistula is one of the complications of intrauterine device (IUD) insertion. Not only may IUD materials cause perforation, but some other risk factors may contribute to its development including uterine abnormalities, thus IUD is contraindicated in patients with anatomical anomaly.

Case: P3A1 woman, 50 years old with a history of IUD use for 16 years presented with complaints of fecal discharge from the vagina 8 months ago which worsened after IUD extraction. Physical examination revealed no abdominal tenderness. Speculum examination found feces in the cervical canal. CT scan examination showed multiple uterocolon fistulas and uterine didelphys. Diagnostic laparoscopy and hysteroscopy were carried out and found a recto-uterine fistula, then the patient was scheduled for colostomy and reanastomosis with the stapler method.

Conclusion: Diagnosis was very difficult to establish despite proper imaging modalities. The use of direct visual diagnostics (hysteroscopy and laparoscopy) can be a good alternative for the diagnosis of uterocolon fistula. To the best of our knowledge, this is the first case report on recto-uterine fistula in a patient with long-term use of IUD and uterine didelphys.

Keywords: IUD; diagnostics; uterine didelphys; uterocolon fistula.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Fistulography with contrast.
Figure 2
Figure 2
Diagnostic laparoscopy and diagnostic hysteroscopy.
Figure 3
Figure 3
Reanastomosis using intraluminal stapler with good result.
See this image and copyright information in PMC

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References

    1. Kho KA, Chamsy DJ. Perforated intraperitoneal intrauterine contraceptive devices: diagnosis, management, and clinical outcomes. J Minim Invasive Gynecol. 2014;21(4):596–601. doi:10.1016/j.jmig.2013.12.123 - DOI - PMC - PubMed
    1. Zeino MY, Wietfeldt ED, Advani V, Ahad S, Younkin C, Hassan I. Laparoscopic removal of a copper intrauterine device from the sigmoid colon. J Soc Laparoendosc Surg. 2011;15(4):568–570. doi:10.4293/108680811X13176785204661 - DOI - PMC - PubMed
    1. Takahashi H, Puttler KM, Hong C, Ayzengart AL. Sigmoid colon penetration by an intrauterine device: a case report and literature review. Mil Med. 2014;179(1):e127–e9. doi:10.7205/MILMED-D-13-00268 - DOI - PubMed
    1. Amies Oelschlager A-M, Debiec K, Micks E, Prager S. Use of the levonorgestrel intrauterine system in adolescents with known uterine didelphys or unicornuate uterus. J Pediatr Adolesc Gynecol. 2013;26(2):e58. doi:10.1016/j.jpag.2013.01.029 - DOI
    1. Espey E, Ogburn T, Hall R, Byrn F. Use of intrauterine device in the setting of uterus didelphys. Obstet Gynecol. 2006;108(3):774–776. doi:10.1097/01.AOG.0000198633.77911.de - DOI - PubMed

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