The European Journal of Contraception & Reproductive Health Care · 2003 · 15 citations · 0 references
InfertilityFertilityCase ReportIntrauterine Contraceptive DeviceReproductive HealthGynecologyMaternal HealthSigmoid ColonBowel PerforationOperative Vaginal DeliverySurgeryObstetricsPublic HealthMedicineIntrauterine Device InsertionReproductive Endocrinology
Copper T intrauterine devices are widely used for family planning but can perforate the uterus and rarely migrate to adjacent organs such as the sigmoid colon. The authors report a case of an IUD that migrated to the sigmoid colon in a 40‑year‑old woman who presented with secondary amenorrhea and pelvic cramps. Diagnostic laparoscopy revealed bowel perforation caused by the migrated IUD, which was removed laparoscopically, followed by a laparotomy to repair the perforation and create a colostomy. Ultrasound identified an 8‑week pregnancy and the IUD positioned outside the uterus near the sigmoid colon; the pregnancy was terminated, the device was removed, and the case highlights the ongoing risk of IUD migration despite technological advances.
Copper T intrauterine devices (IUDs) remain the mainstay of family planning measures in developing countries, but have been associated with serious complications such as bleeding, perforation and migration to adjacent organs or omentum. Although perforation of the uterus by an IUD is not uncommon, migration to the sigmoid colon is extremely rare. Here, we report a case of migration of an IUD to the sigmoid colon.A 40-year-old woman who had an IUD (Copper T), inserted 1 month after delivery, presented, 7 months later, with secondary amenorrhea and transient pelvic cramps. Clinical findings and ultrasonographic examinations of the patient revealed an 8-week pregnancy, while laboratory tests were normal. Transvaginal ultrasonography also visualized the IUD located outside the uterus, near the sigmoid colon, as if it were attached to the bowel. The pregnancy was terminated at the patient's wish; a diagnostic laparoscopy was performed concomitantly, which showed bowel perforation owing to the migration of the IUD. The device, which was partially embedded in the sigmoid colon, was removed via laparoscopy; however, because of bowel perforation, laparotomy was performed to open colostomy.This case report highlights the continuing need for intra- and postinsertion vigilance, since even recent advances in IUD technique and technology do not guarantee risk-free insertion.