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Large bowel obstruction due to intrauterine device: associated pelvic inflammatory disease.
Am Surg. 1999 Dec; 65(12):1165-6.AS

Abstract

Pelvic actinomycosis associated with the use of intrauterine contraceptive devices (IUDs) can mimic pelvic malignancy. Recognizing this rare, but not uncommon complication of IUD use can spare a patient from an extensive surgical procedure. If recognized preoperatively, a simple regimen of antibiotics can be curative; however, if symptomatic, a limited surgical procedure is warranted. We present the case of a 55-year-old woman with a slow, indolent course of partial large bowel obstruction and a history of IUD use for over 20 years. A preoperative CT scan revealed a frozen pelvis mimicking a pelvic malignancy. Exploratory laparotomy revealed a firm, indurated, fibrotic reaction in the pelvis involving the uterus, adnexa, and sigmoid colon. A diverting loop colostomy was performed, and pathology revealed sulfur granules from the extracted IUD that grew Actinomyces. The patient was treated with the appropriate antibiotics, and during the takedown of the colostomy 6 months later the pelvic inflammation was completely resolved. An extensive review of the literature involving actinomycotic abscesses associated with IUD use reveals a limited number of studies reported in the general surgical literature. It behooves the general surgeon to be aware of this unusual case so that the appropriate consultation and treatment can be performed with limited morbidity to the patient.

Authors+Show Affiliations

Department of Surgery, St. Francis Medical Center, Trenton, New Jersey, USA.No affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

10597067

Citation

Antonelli, D, and J F. Kustrup. "Large Bowel Obstruction Due to Intrauterine Device: Associated Pelvic Inflammatory Disease." The American Surgeon, vol. 65, no. 12, 1999, pp. 1165-6.
Antonelli D, Kustrup JF. Large bowel obstruction due to intrauterine device: associated pelvic inflammatory disease. Am Surg. 1999;65(12):1165-6.
Antonelli, D., & Kustrup, J. F. (1999). Large bowel obstruction due to intrauterine device: associated pelvic inflammatory disease. The American Surgeon, 65(12), 1165-6.
Antonelli D, Kustrup JF. Large Bowel Obstruction Due to Intrauterine Device: Associated Pelvic Inflammatory Disease. Am Surg. 1999;65(12):1165-6. PubMed PMID: 10597067.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Large bowel obstruction due to intrauterine device: associated pelvic inflammatory disease. AU - Antonelli,D, AU - Kustrup,J F,Jr PY - 1999/12/22/pubmed PY - 2001/3/28/medline PY - 1999/12/22/entrez SP - 1165 EP - 6 JF - The American surgeon JO - Am Surg VL - 65 IS - 12 N2 - Pelvic actinomycosis associated with the use of intrauterine contraceptive devices (IUDs) can mimic pelvic malignancy. Recognizing this rare, but not uncommon complication of IUD use can spare a patient from an extensive surgical procedure. If recognized preoperatively, a simple regimen of antibiotics can be curative; however, if symptomatic, a limited surgical procedure is warranted. We present the case of a 55-year-old woman with a slow, indolent course of partial large bowel obstruction and a history of IUD use for over 20 years. A preoperative CT scan revealed a frozen pelvis mimicking a pelvic malignancy. Exploratory laparotomy revealed a firm, indurated, fibrotic reaction in the pelvis involving the uterus, adnexa, and sigmoid colon. A diverting loop colostomy was performed, and pathology revealed sulfur granules from the extracted IUD that grew Actinomyces. The patient was treated with the appropriate antibiotics, and during the takedown of the colostomy 6 months later the pelvic inflammation was completely resolved. An extensive review of the literature involving actinomycotic abscesses associated with IUD use reveals a limited number of studies reported in the general surgical literature. It behooves the general surgeon to be aware of this unusual case so that the appropriate consultation and treatment can be performed with limited morbidity to the patient. SN - 0003-1348 UR - https://www.unboundmedicine.com/medline/citation/10597067/Large_bowel_obstruction_due_to_intrauterine_device:_associated_pelvic_inflammatory_disease_ L2 - https://medlineplus.gov/pelvicinflammatorydisease.html DB - PRIME DP - Unbound Medicine ER -