Elective Surgical Removal of Migrated Intrauterine Contraceptive Devices From Within the Peritoneal Cavity: A Comparison Between Open and Laparoscopic Removal

Abstract

This study supports the use of laparoscopic surgery for the elective removal of migrated intrauterine contraceptive devices (IUCD) from within the peritoneal cavity.

Perforation of the appendix and the sigmoid colon by an ectopic IUD

“…1 Approximately half of all patients with translocated intrauterine devices are reported as asymptomatic and unaware of their missing IUD until incidental discovery on routine imaging or onset of pregnancy. 1 There are an estimated 1.3 to 1.8 uterine perforation by IUDs per 1000 insertions 1,2 with an average age at discovery below 30yrs of age.…”

“…1 Approximately half of all patients with translocated intrauterine devices are reported as asymptomatic and unaware of their missing IUD until incidental discovery on routine imaging or onset of pregnancy. 1 There are an estimated 1.3 to 1.8 uterine perforation by IUDs per 1000 insertions 1,2 with an average age at discovery below 30yrs of age. 1 Appendiceal or Sigmoid colon injury from an IUD penetration is a rarity Intrauterine device migration is typically into the pelvic cavity or into surrounding structures such as the sigmoid colon, appendix, urinary bladder, omentum and retroperitoneum.…”

“…1 There are an estimated 1.3 to 1.8 uterine perforation by IUDs per 1000 insertions 1,2 with an average age at discovery below 30yrs of age. 1 Appendiceal or Sigmoid colon injury from an IUD penetration is a rarity Intrauterine device migration is typically into the pelvic cavity or into surrounding structures such as the sigmoid colon, appendix, urinary bladder, omentum and retroperitoneum. 1 Acute appendicitis or appendiceal perforation as a complication of intrauterine device insertion has been documented in the literature.…”

“…1 Appendiceal or Sigmoid colon injury from an IUD penetration is a rarity Intrauterine device migration is typically into the pelvic cavity or into surrounding structures such as the sigmoid colon, appendix, urinary bladder, omentum and retroperitoneum. 1 Acute appendicitis or appendiceal perforation as a complication of intrauterine device insertion has been documented in the literature. 3 Lack of features of perforated bowel or abdominal sepsis in our case might be due to a chronically sealed perforation with associated phlegmon.…”

“…5 Early presentations are most often symptomatic and most frequently include complaints of abdominal and pelvic pain, while late presentations are usually assymptomatic with complaints of missing IUD strings on selfexamination or pregnancy. 1,6,7 According to Balci et al the diagnosis of ectopic Intrauterine device can often made with ultrasonography as first line and pelvic radiography should be recommended when ultrasonography fails to locate the missing device. 7 Taras and Kaufman recommended either…”