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Laparoscopic retrieval of intrauterine device perforating the sigmoid colon.
JSLS 2010 Jul-Sep; 14(3):453-5JSLS

Abstract

INTRODUCTION

The intrauterine device (IUD) is a well-tolerated, widely used contraceptive. A major but infrequent complication of the IUD is perforation of the uterus or cervix and migration of the device into the abdomen. Our case of laparoscopic retrieval of an IUD perforating the sigmoid colon illustrates this rare complication.

METHODS

A 36-year-old woman with a history of IUD placement 4 years earlier presented with complaints of abdominal pain and bright red blood per rectum. She had conceived 9 months after IUD placement and suffered a spontaneous abortion requiring an evacuation of the retained products of conception. At presentation, she was afebrile with normal vital signs. Physical examination was significant for tenderness to palpation over the left lower quadrant.

RESULTS

Computed tomography (CT) scans of the abdomen and pelvis showed a foreign body through the wall of the uterus and entering the colon. Colonoscopy revealed an IUD penetrating the sigmoid wall, and multiple failed attempts were made to remove the IUD colonoscopically. Diagnostic laparoscopy was performed that revealed an IUD perforating the uterus and entering the sigmoid. The IUD was manipulated free and removed, and a suture closed the sigmoid defect. The patient was discharged home on the first postoperative day without complication.

CONCLUSIONS

The IUD is one of the most effective, safe, and economic contraceptive methods. Uterine perforation and intraperitoneal translocation is an unusual complication of an IUD. Perforation of hollow viscous is likely even less common. Confirmation of a "missing" IUD is mandatory if pregnancy occurs after IUD placement. Removal of a translocated IUD is recommended, and operative laparoscopy is the preferred method.

Authors+Show Affiliations

Department of Surgery, Swedish Medical Center, Seattle, Washington, USA.No affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

21333209

Citation

Taras, Angie R., and Jedediah A. Kaufman. "Laparoscopic Retrieval of Intrauterine Device Perforating the Sigmoid Colon." JSLS : Journal of the Society of Laparoendoscopic Surgeons, vol. 14, no. 3, 2010, pp. 453-5.
Taras AR, Kaufman JA. Laparoscopic retrieval of intrauterine device perforating the sigmoid colon. JSLS. 2010;14(3):453-5.
Taras, A. R., & Kaufman, J. A. (2010). Laparoscopic retrieval of intrauterine device perforating the sigmoid colon. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 14(3), pp. 453-5. doi:10.4293/108680810X12924466006684.
Taras AR, Kaufman JA. Laparoscopic Retrieval of Intrauterine Device Perforating the Sigmoid Colon. JSLS. 2010;14(3):453-5. PubMed PMID: 21333209.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic retrieval of intrauterine device perforating the sigmoid colon. AU - Taras,Angie R, AU - Kaufman,Jedediah A, PY - 2011/2/22/entrez PY - 2011/2/22/pubmed PY - 2011/5/11/medline SP - 453 EP - 5 JF - JSLS : Journal of the Society of Laparoendoscopic Surgeons JO - JSLS VL - 14 IS - 3 N2 - INTRODUCTION: The intrauterine device (IUD) is a well-tolerated, widely used contraceptive. A major but infrequent complication of the IUD is perforation of the uterus or cervix and migration of the device into the abdomen. Our case of laparoscopic retrieval of an IUD perforating the sigmoid colon illustrates this rare complication. METHODS: A 36-year-old woman with a history of IUD placement 4 years earlier presented with complaints of abdominal pain and bright red blood per rectum. She had conceived 9 months after IUD placement and suffered a spontaneous abortion requiring an evacuation of the retained products of conception. At presentation, she was afebrile with normal vital signs. Physical examination was significant for tenderness to palpation over the left lower quadrant. RESULTS: Computed tomography (CT) scans of the abdomen and pelvis showed a foreign body through the wall of the uterus and entering the colon. Colonoscopy revealed an IUD penetrating the sigmoid wall, and multiple failed attempts were made to remove the IUD colonoscopically. Diagnostic laparoscopy was performed that revealed an IUD perforating the uterus and entering the sigmoid. The IUD was manipulated free and removed, and a suture closed the sigmoid defect. The patient was discharged home on the first postoperative day without complication. CONCLUSIONS: The IUD is one of the most effective, safe, and economic contraceptive methods. Uterine perforation and intraperitoneal translocation is an unusual complication of an IUD. Perforation of hollow viscous is likely even less common. Confirmation of a "missing" IUD is mandatory if pregnancy occurs after IUD placement. Removal of a translocated IUD is recommended, and operative laparoscopy is the preferred method. SN - 1086-8089 UR - https://www.unboundmedicine.com/medline/citation/21333209/Laparoscopic_retrieval_of_intrauterine_device_perforating_the_sigmoid_colon_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21333209/ DB - PRIME DP - Unbound Medicine ER -