Pelvic abscess complicating sigmoid colon perforation by migrating intrauterine device: A case report and review of the literature

Toumi, Omar; Ammar, Houssem; Ghdira, Abdessalem; Chhaidar, Amine; Trimech, Wided; Gupta, Rahul; Salem, R.; Saad, Jamel; Korbi, Ibtissem; Nasr, Mohamed; Noomen, Faouzi; Golli, M.; Zouari, Khadija

doi:10.1016/j.ijscr.2017.10.038

Cited by 22 publications

(20 citation statements)

References 21 publications

(57 reference statements)

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“…The other two cases presented with pelvic pain, dyspareunia and vaginal/rectal bleeding. In both cases, the missed IUCDs were found penetrating the sigmoid colon 12 13. One of them had failed attempts at endoscopic and laparoscopic retrievals and was therefore treated by open resection and primary anastomosis 12.…”

Section: Discussionmentioning

confidence: 98%

“…This emphasises the importance of performing the appropriate imaging such as anteroposterior X-rays and pelvic ultrasonography before assuming ‘spontaneous’ expulsion of a missing IUCD. Review of the literature revealed only three similar cases in which two IUCDs were discovered at the time of presentation 12–14. One case was that of a 77-year-old woman who was found during routine colonoscopy for iron-deficiency anaemia to have one IUCD penetrating the transverse colon and the other was eroding into the rectum 14.…”

Section: Discussionmentioning

confidence: 99%

“…One of them had failed attempts at endoscopic and laparoscopic retrievals and was therefore treated by open resection and primary anastomosis 12. The other was treated by open wedge resection of the involved segment 13. The details of these three cases are summarised in table 1.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic removal of an incidentally discovered intrauterine contraceptive device eroding into the rectum

et al. 2019

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Intrauterine contraceptive device (IUCD) is a common birth control method. It is safe but can be associated with serious complications including migration into the peritoneal cavity and penetration into other intra-abdominal and pelvic viscera; most commonly the rectosigmoid colon. Different retrieval methods including endoscopy, laparoscopy or open abdominal surgery have been described. We report the case of 38-year-old woman who became pregnant shortly after insertion of the IUCD 6 years prior to presentation. She delivered vaginally and ‘expulsion’ of the device was assumed. Some 4 years later, she had another IUCD inserted and remained asymptomatic till she recently presented with iron-deficiency anaemia. As part of the investigation, diagnostic colonoscopy was performed. Surprisingly, the old IUCD was found penetrating into the midrectum. Uneventful endoscopic removal was performed and she remained well at 3-month follow-up. Migrating IUCD remains asymptomatic and may be discovered accidentally during routine investigation for some other symptoms.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Endoscopic removal of an incidentally discovered intrauterine contraceptive device eroding into the rectum

et al. 2019

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“…However, its success rate varies between 44% and 100%, depending on the presented complication and the surgeon's expertise. Up to 25% may have the necessity of conversion to laparotomy (3,6,8).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopy Approach to Sigmoid Colon Perforation Secondary to Intrauterine Device Migration

Amortegui¹,

Vanegas²,

Blanquicet³

et al. 2020

Preprint

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Background Currently, the intrauterine device (IUD) is one of the most used contraceptive methods worldwide, since it has shown to be effective and reversible. One of its complications is the migration of the device, which can affect close organs by perforating them. Case We present the case of a patient who presented a colouterine fistula secondary to an IUD migration. Conclusion Laparoscopy is a surgical method that may be performed electively; it makes device removal and repair of affected organs possible with fewer complications.

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“…Perforation appears to be related to the type of device, [ 8 ] time of insertion, breastfeeding, [ 9 , 10 ] position of the uterus, skill of the operator, and compliance with follow-up. [ 11 , 12 ] Perforation usually occurs at the time of insertion [ 13 , 14 ] ; however, delayed perforation is also reported in the literature, but the incidence rate is lower than that in the former category. [ 15 ] These patients may present with pregnancy or lost strings or may remain asymptomatic for several years.…”

Section: Discussionmentioning

confidence: 99%

Migration of a foreign body to the rectum

Yang¹,

Huang

Zhou³

et al. 2018

Medicine

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Rationale:Rectal foreign bodies are not an uncommon finding in outpatient departments globally. Most such objects are inserted through the anus. Occasionally, a foreign body may be ingested and may successfully pass through the entire gastrointestinal tract and be held up in the rectum. In extremely rare cases, foreign bodies in adjacent tissues or organs can penetrate the rectal wall and enter the rectal lumen. We report a rare case that the IUCD had migrated and was embedded in the rectal wall. A part of the IUCD was loosened and deformed into a metallic wire that protruded through the anus.Patient concerns:A 45-year-old woman presented with complaints of a metallic wire protruding through her anus when she used the washroom. The wire would become longer when she manually pulled it; however, this process was associated with pain in the lower abdomen, and she therefore stopped manipulating it.Diagnoses:A rectal foreign body secondary to intrauterine contraceptive device (IUCD) migration and rectal perforation, as well as a pelvic cyst.Interventions:Under general anesthesia, she underwent laparoscopic removal of the rectal foreign body, pelvic adhesiolysis, pelvic cyst resection, and ileostomy combined with colonoscopy.Outcomes:Her postoperative recovery was uneventful.Lessons:Foreign bodies in adjacent tissues or organs can penetrate the rectal wall and enter the rectal lumen. Regular follow-up after IUCD insertion is very important. We report this rare case that would increase awareness among clinicians regarding the differential diagnosis and treatment in such cases.

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Pelvic abscess complicating sigmoid colon perforation by migrating intrauterine device: A case report and review of the literature

Cited by 22 publications

References 21 publications

Endoscopic removal of an incidentally discovered intrauterine contraceptive device eroding into the rectum

Endoscopic removal of an incidentally discovered intrauterine contraceptive device eroding into the rectum

Laparoscopy Approach to Sigmoid Colon Perforation Secondary to Intrauterine Device Migration

Migration of a foreign body to the rectum

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