PubMed · 2005 · 28 citations · 0 references
MedicineGynecologySurgeryBowel ManagementGastroenterologyReproductive MedicineBowel PreparationColorectal SurgeryGastrointestinal PerforationIntrauterine ContraceptionIntrauterine DevicesLaparoscopic SurgeryBowel Preparation RegimensGastrointestinal Perforation ManagementIud RemovalLower Abdominal PainPelvic Inflammatory Disease ManagementPreoperative Bowel Preparation
BACKGROUND: Intrauterine device (IUD) perforation of the bowel is uncommon. Although IUD perforation may be asymptomatic, the most common complaint is unexplained abdominal pain. CASE: A case of IUD perforation of the large bowel was diagnosed 7 years after insertion. The patient presented with unexplained lower abdominal pain diagnosed initially as pelvic inflammatory disease. Laparoscopy revealed that the IUD was embedded deeply in the rectum. Bowel preparation and intravenous antibiotics followed by colonoscopy using a grasping snare resulted in successful IUD removal. CONCLUSION: Patients presenting with IUDs embedded in the large bowel may benefit from attempted removal using colonoscopy rather than laparotomy. Bowel preparation, intravenous antibiotics and pos-textraction evaluation to rule out perforation may be prudent.