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Case Reports
. 2024 Dec 30;24(1):672.
doi: 10.1186/s12905-024-03522-0.

Migrated intra-uterine device to infra-umbilical skin: a rare case report

Nigat Amsalu Addis  1 , Yared Alem Sibhat  2 , Yohannis Derbew Molla  3 , Wasihun Nigdu Mengestu  2 , Abebe Sinknew Seid  4 , Michael Argaw Damite  5 , Misganaw Abere Worku  2
Affiliations
Case Reports

Migrated intra-uterine device to infra-umbilical skin: a rare case report

Nigat Amsalu Addis et al. BMC Womens Health. .

Abstract

Introduction: IUDs are effective, reversible and safe methods of contraception. The mechanism of action of IUDs as a group is inducing endometrial atrophy, apoptosis, altering tubal motility; preventing sperm permeability, fertilization, and implantation. Complications of IUD include menstrual disturbance, pelvic pain, and increased risk of ectopic pregnancy with contraceptive failure, device expulsion, uterine perforation or transmural migration with misplacement of the device. Pregnancies and IUD migration are uncommon complications, occurring in 1 to 2 from 1,000 users. The clinical presentation of migrated IUDs depends on the final anatomic location at diagnosis. Migration can be asymptomatic and incidentally found while imaging for any other diagnosis or may have various acute clinical presentations.

Case presentation: We present the case of a 38-years-old Ethiopian woman with unusual migration of IUD to the infra-umbilical skin. She had infra-umbilical skin discoloration associated with intermittent itching for two months duration. On physical examination, there was diffuse violaceous patch over the infra-umbilical skin measuring 7 centimeters on its longest dimension and visible foreign body (IUD) with tiny sinus tract formation. Visible stem of copper-containing IUD was grasped by ring forceps and removed with gentle traction without complication during or following extraction. Removal of misplaced IUD with completely non-invasive manner makes this case special in addition to the unique site of migration to the infra-umbilical skin.

Conclusion and recommendation: To our knowledge, this is what likely to be the first reported case of IUD migration to the infra-umbilical skin which bestows a new finding to the existing literatures. Despite rare occurrence, possible IUD complications should be included in the informed consent process before insertion. Self-examination of the strings and vigilant evaluation at regular checkup is recommended for early detection of migrated IUDs.

Keywords: Case report; Infra-umbilical skin; Intrauterine device; Migration; Violaceous Patch.

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Conflict of interest statement

Declarations. Ethical approval and patient consent: This case report has been submitted to the school of medicine at University of Gondar College of medicine and health sciences for ethical board review and was approved as morally sound report. A written informed consent was obtained from the patient for publication of the case report and accompanying images. A copy of patient’s written consent is available for review for the editor-in-chief of this journal. Conflict of interest: None Declared.

Figures

Fig. 1
Fig. 1
Diffuse violaceous patch over the infra-umbilical skin and visible foreign body (IUD) with sinus tract formation (pointed by the black arrow)
Fig. 2
Fig. 2
Empty uterus with trilaminar pattern seen on trans-abdominal ultrasound in sagittal plane
Fig. 3
Fig. 3
Copper T-380 A IUD removed completely with ring forceps
Fig. 4
Fig. 4
Cartoon drawing showing presumed trajectory paths of IUD migration to the Infra-umbilical skin
See this image and copyright information in PMC

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References

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