A new endoscopic method of retrieval of a migrated and transmurally embedded intrauterine contraceptive device in the rectum

Abstract

A 45-year-old lady presented with left lower quadrant abdominal pain and hematochezia of 1 month duration. She had Copper-T, an intrauterine contraceptive device (IUCD) inserted in the immediate post-partum period 25 years ago elsewhere and was lost to follow up. CT abdomen done 2 weeks earlier before reporting to us revealed a migrated and translocated IUCD embedded in the right lateral wall of the rectum. On colonoscopy, an area of friable mucosal nodule was noticed in the right lateral wall 10 cm from the anal verge but the IUCD was not visible intraluminally. Fluoroscopy showed the horizontal limb lying in close approximation with the rectal wall and the vertical limb of the IUCD embedded at the site of mucosal nodule in the rectum. After a careful endoscopic mucosotomy, the vertical limb was exposed and the Copper-T in its entirety was retrieved using a polypectomy snare. The mucosal defect was closed with hemoclips. She became asymptomatic after the procedure.

Complete sigmoid colon erosion by an intrauterine contraception device in an ectopic pregnancy: a case report

“…Although an IUCD embedded in the colon wall can be removed endoscopically, 8 we removed the IUCD with a colotomy, as this is technically more straightforward when the abdomen is already accessed in response to a leaking ectopic pregnancy. If an IUCD is found incidentally, endoscopic retrieval may be attempted, but this may pose a risk of colon perforation, as part of the IUCD may be deeply embedded.…”