Migration of an intrauterine contraceptive device to the sigmoid colon: a case report.
BACKGROUND
Copper T intrauterine devices (IUDs) remain the mainstay of family planning measures in developing countries, but have been associated with serious complications such as bleeding, perforation and migration to adjacent organs or omentum. Although perforation of the uterus by an IUD is not uncommon, migration to the sigmoid colon is extremely rare. Here, we report a case of migration of an IUD to the sigmoid colon.


METHODS
A 40-year-old woman who had an IUD (Copper T), inserted 1 month after delivery, presented, 7 months later, with secondary amenorrhea and transient pelvic cramps. Clinical findings and ultrasonographic examinations of the patient revealed an 8-week pregnancy, while laboratory tests were normal. Transvaginal ultrasonography also visualized the IUD located outside the uterus, near the sigmoid colon, as if it were attached to the bowel. The pregnancy was terminated at the patient's wish; a diagnostic laparoscopy was performed concomitantly, which showed bowel perforation owing to the migration of the IUD. The device, which was partially embedded in the sigmoid colon, was removed via laparoscopy; however, because of bowel perforation, laparotomy was performed to open colostomy.


CONCLUSIONS
This case report highlights the continuing need for intra- and postinsertion vigilance, since even recent advances in IUD technique and technology do not guarantee risk-free insertion.
Celal Bayar University School of Medicine, Department of Obstetrics and Gynecology, Manisa, Turkey.
U S
US
Nceboz
H T
HT
Ozçakir
Y
Y
Uyar
H
H
Cağlar
D000328:Adult; D012809:Colon, Sigmoid / Q000000981:diagnostic imaging / Q000601:surgery*; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007435:Intrauterine Devices, Copper / Q000009:adverse effects*; D010535:Laparoscopy / Q000379:methods; D017699:Pelvic Pain / Q000175:diagnosis / Q000209:etiology; D018570:Risk Assessment; D014463:Ultrasonography; D014595:Uterine Perforation / Q000209:etiology / Q000601:surgery