Intrauterine contraceptive device appendicitis: A case report

Abstract

Uterine perforation is one of the serious complications associated with use of the intrauterine contraceptive device (IUD). Uterine perforation by IUD can involve several neighboring organs. A case of acute appendicitis was caused by a Multiload Cu 375 IUD inserted previously. This is a rare complication and only fourteen previous cases were recorded in the literature.

Mystery of the missing loop

“…8 Disappearance of thread without history of spontaneous expulsion might trigger off search for missing device. 3,8 Imaging forms the backbone of detecting displaced IUCDs, symptomatic or otherwise. [1][2][3][4][5][6][7][8] Hysteroscopy, cystoscopy, endoscopy, plain radiographs, ultrasonography and CT have been used singly or in combination to locate the displaced IUCDs.…”

“…[1][2][3][4][5][6][7] Perforation of hollow viscous, intractable lower abdominal pain, persistent pelvic inflammatory disease, recurrent urinary infections, vesical stone formation and intestinal obstruction are some of the presentations. [1][2][3][4][5][6][7] However, IUCDs, such as, Lippes loop, are quite inert and cause little symptoms, hence, are detected incidentally, as evident by this case. 8 Disappearance of thread without history of spontaneous expulsion might trigger off search for missing device.…”

“…[1][2][3][4][5][6][7] Most of the IUCD migrations have been of copper T which incites copious tissue reaction and is, hence, symptomatic. [1][2][3][4][5][6][7] Perforation of hollow viscous, intractable lower abdominal pain, persistent pelvic inflammatory disease, recurrent urinary infections, vesical stone formation and intestinal obstruction are some of the presentations. [1][2][3][4][5][6][7] However, IUCDs, such as, Lippes loop, are quite inert and cause little symptoms, hence, are detected incidentally, as evident by this case.…”

“…[1][2][3][4][5][6][7][8] Management options for symptomatic migrations range from formal open surgery to minimally invasive techniques, depending upon the presentation/situation. 1,3,5,7 Opinion is divided regarding retrieval of those migrated IUCDs that do not cause any symptoms.…”

“…[1][2][3][4][5][6][7][8] Hysteroscopy, cystoscopy, endoscopy, plain radiographs, ultrasonography and CT have been used singly or in combination to locate the displaced IUCDs. [1][2][3][4][5][6][7][8] Management options for symptomatic migrations range from formal open surgery to minimally invasive techniques, depending upon the presentation/situation. 1,3,5,7 Opinion is divided regarding retrieval of those migrated IUCDs that do not cause any symptoms.…”