Paucisymptomatic Migrated Intrauterine Contraceptive Device to the Sigmoid Colon: A Case Report

Abstract

Background: Migration of intrauterine contraceptive device (IUCD) to adjacent organs is rare but the most serious complication. Withdrawal of any migrated IUCD is advisable even if asymptomatic and Laparoscopic removal remain the gold standard, however sometimes finding the device intra-operatively is challenging for the surgeon. Case presentation: We report a case of laparoscopic removal of migrated IUCD to the sigmoid colon. Computed tomography (CT) precisely located the migrated device embedded in the sigmoid colon. After failure of endoscopic attempt to remove the device, laparoscopy was then performed. On initial laparoscopic examination no adhesions were found, the uterus, ovaries & tubes were normal in appearance, however a small bud was identified on the anterior surface of the descending branch of the sigmoid colon. This bud was related to one arm of the T shaped IUCD in fluoroscopy. During dissection around the bud fortunately one arm of the device was seen and then the IUCD was easily extracted, then separate stitches were done to suture the opening of the colon. Postoperative outcomes were uneventful. Conclusion: Migrated IUCD can be removed safely by laparoscopy. Preoperative precise localization is accurate and Intraoperative fluoroscopy guidance is helpful to find the missed device.