Cecum perforation following intrauterine device insertion: a case report

Document Type : Case report

Authors

1 Assistant professor, Department of Gynecology and Obstetrics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

2 Resident Fellowship of Infertility, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: Intrauterine device (IUD) is an effective and reliable contraceptive method. It is one of the most frequently used methods in our country. Colon perforation is a rare but serious complication occurring sometimes years after insertion. In this report, a patient with cecum perforation following IUD insertion who presented with acute abdomen was reported.
Case Presentation: The patient was a 30 year old female who admitted to the clinic of Arash Women's Comprehensive Hospital with complaints of hypogastric abdominal pain and spotting. She had a natural vaginal delivery 6 months ago and an IUD was inserted one week before referring. On abdominal examination, there was pain in the hypogastric region with deep palpation and there was positive cervical motion tenderness. Abdominal ultrasonography did not show IUD in uterine cavity. Abdominal X-ray was done and IUD was seen in abdominal cavity. Emergent Laparascopy was done. Two cecum perforations by an intrauterine device were diagnosed, and the intestinal damage was repaired with a laparatomic approach.
Conclusion: IUD migration and uterine and colon perforation is a rare but serious complication that should be considered in differential diagnosis of each woman with IUD who has abdominal pain. Laparoscopic approach for intrauterine device removal is a simple and safe approach if further complications are not likely.

Keywords

References

  1. Heartwell SF, Schlesselman SA. Risk of uterine perforation among users of intrauterine devices. Obstetrics and gynecology 1983; 61(1):31-6.
  2. Bitterman A, Lefel O, Segev Y, Lavie O. Laparoscopic removal of an intrauterine device following colon perforation. JSLS: Journal of the Society of Laparoendoscopic Surgeons 2010; 14(3):456.
  3. Gonenc M, Kalayci MU, Turhan AN, Deniztas C, Alis H. Endoscopic treatment of a transmigrated intrauterine device to colonic wall: a case report. American journal of obstetrics and gynecology 2011; 204(3):e3-5.
  4. Günakan E, Buluş H, Polat F. Colonic perforation due to the migration of an intrauterine device (IUD): surgical management for acute abdomen. Ortadoğu Tıp Dergisi 2018; 10(1):85-8.
  5. Gill RS, Mok D, Hudson M, Shi X, Birch DW, Karmali S. Laparoscopic removal of an intra-abdominal intrauterine device: case and systematic review. Contraception 2012; 85(1):15-8.
  6. Aliukonis V, Lasinskas M, Pilvelis A, Gradauskas A. Intrauterine device migration into the lumen of large bowel: A case report. International journal of surgery case reports 2020; 72:306-8.
  7. Tabatabaei F, Masoumzadeh M. Dislocated intrauterine devices: clinical presentations, diagnosis and management. The European Journal of Contraception & Reproductive Health Care 2021; 26(2):160-6.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 24, Issue 12
January 2022
Pages 132-136

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