Ovarian embedding of a transmigrated intrauterine device: a case report and literature review

Verma, Usha; Verma, Nupur

doi:10.1007/s00404-008-0882-2

Cited by 19 publications

(21 citation statements)

References 16 publications

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“…The triad of symptoms most often experienced by women with intestinal injuries includes chronic abdominal pain, fever, and intermittent diarrhea. In the present case, however, the patient complained of feeling strings near her anus (6)(7)(8).…”

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confidence: 62%

A new technique for the removal of a transmigrated intrauterine device with rectum penetration

Toprak

Gokturk²,

Tolu³

2015

Turk J Gastroenterol

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rectal examination. Colonoscopy revealed that the transverse arms and a part of the horizontal arm of the IUD had penetrated the rectum at 10 cm with protruding strings in the lumen (Figure 2). Retrieval of the IUD by pulling on the threads was attempted but unsuccessful, as the IUD was firmly adherent to the colon wall. Because pulling the strings vigorously to remove the IUD could have resulted in intestinal defects that may have required surgical repair, we decided to remove the IUD by applying traction force. A rubber band was fastened to the strings of the IUD and was stretched by pulling it thorough the anus where the free end of the rubber band was fixed to the buttocks with adhesive tape (Figure 3). The patient was called, and traction applied by the rubber band was checked every other day. On day 4 of the procedure, the IUD was expelled. The area in which the IUD had been embedded was clear.The present case report describes a rectal transmigration of an IUD and its endoscopic removal using a rubber band traction technique without the need for surgery. IUDs are among the most common reversible methods of contraception worldwide. Uterine perforation is the most serious complication associated with IUD insertion, with an estimated incidence of 0 to 10 perforations per 1,000 insertions. Perforations commonly occur at the time of insertion or shortly thereafter, but may also occur many years later. Although the exact mechanism of IUD transmigration accompanied by uterine perforation is not known, the most important risk factors are the skill of the operator; the features of the IUD; the size, shape, and configuration of the uterus; past operations; and timing of insertion after delivery. In the present case, uterine abnormalities were not detected, and there was no previous operation history (3-5).It should be noted that the majority of uterine perforations do not affect other organs; however, 15% of cases lead to complications in adjacent organs, specifically the intestine. Intestinal complications caused by IUD migration include obstruction, infarction, perforation, fistula formation, and mesenteric injury. Penetration of the intestine by an IUD occurs most commonly in the sigmoid colon (40.4%), followed by the small intestine (21.3%) and rectum (21.3%). Patients presenting with uterine perforation may experience pelvic pain, excessive bleeding, and fever; however, migration may be asymptomatic in approximately one-third of patients. The triad of symptoms most often experienced by women with intestinal injuries includes chronic abdominal pain, fever, and intermittent diarrhea. In the present case, however, the patient complained of feeling strings near her anus (6-8).The diagnosis of a transmigrated or dislocated IUD is made by clinical, radiological, and ultrasonographic examination. However, pregnancy should be ruled out before any diagnostic procedure. Other examinations, including hysterography, hysteroscopy, colonoscopy, and laparoscopy, should also be performed as needed. Despite the presence of an I...

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contrasting

confidence: 62%

A new technique for the removal of a transmigrated intrauterine device with rectum penetration

Toprak

Gokturk²,

Tolu³

2015

Turk J Gastroenterol

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“…X-ray will not only reveal the presence or absence of the device but also its existence outside the uterine cavity [2]. The examination is simple, fast and is quite inexpensive [3]. Abdominal CT scan may be used to better define the anatomical locations and relationship of the IUCDs with neighboring structures [3].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and management of two intrapelvic mislocated intrauterine contraceptive devices: A very rare case

Hooda¹,

Bhugra²

2015

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. IJCRI publishes Review

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“…[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.…”

Section: Case Reportmentioning

confidence: 99%

“…[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.…”

Section: Case Reportmentioning

confidence: 99%

“…[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.…”

Section: Case Reportmentioning

confidence: 99%

See 1 more Smart Citation

Mystery of the missing loop

Bharathi

Chakladar

Kumari

2011

Medical Journal Armed Forces India

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Ovarian embedding of a transmigrated intrauterine device: a case report and literature review

Cited by 19 publications

References 16 publications

A new technique for the removal of a transmigrated intrauterine device with rectum penetration

A new technique for the removal of a transmigrated intrauterine device with rectum penetration

Diagnosis and management of two intrapelvic mislocated intrauterine contraceptive devices: A very rare case

Mystery of the missing loop

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