A lost intrauterine device. Guess where we found it and how it happened?

Abstract

Perforation of the uterus by an intrauterine device (IUD) is a serious complication occurring at or following 1/350 to 1/2,500 insertions. It is more common among women with 'lost' IUDs. If a woman presents with pelvic pain and a history of a 'lost' IUD, X-rays of the abdomen and of the pelvis should be ordered. We report on a 'lost' IUD that had been inserted 12 years previously. It was found in the lower anterior abdominal wall. Most probably uterine perforation had happened during a dilatation and curettage (D & C) attempted for removal of the device. Thereafter the IUD must have migrated to the abdominal wall. This case illustrates that unless it can be recovered by simple traction on the threads, a trained medical professional should be called upon for removal of the IUD.

Fallopian tube insertion into the uterine cavity discovered accidentally during laparoscopic retrieval of a misplaced coil from the pelvic cavity

“…In our case, fibrin deposits had already formed around the coil, which was surprisingly early considering that only 4 days had past since its insertion. The laparoscopic location of the coil can be tricky if there is no sign of adhesions [8]. An abdominal X-ray can point out the side where the coil is located.…”

Asymptomatic far-migration of an intrauterine device into the abdominal cavity: A rare entity

“…IUDs should be examined periodically. 3 An ultrasound is a simple, rapid and non-invasive imaging method to assess the position of the IUD.…”

“…[1][2][3] Perforation of the uterus due to IUD placement may be seen soon after the procedure or as a delayed event. It has been advocated that IUDs should be placed following proper patient selection by trained clinicians.…”

“…2 There are not many reports on the the far-migration of an IUD. 2,3 The longer the distance from the uterus, the more likely the patient will have severe symptoms. 2 Our case describes a patient with a far-migrated intraabdominal IUD causing no symptoms over the past 30 years and detected incidentally.…”

“…1,2 Uterine perforation due to an IUD is seen in 0.05 to 13 cases out of 1000 IUD placements. 1,3,4 Uterine perforation following IUD insertion may be observed during or soon after the procedure or as a delayed event. 1,2,4 Delayed rupture can be due to uterine spasms.…”