[Uterine and jejunum perforation due to intrauterine device. A report of a case and literature review].
The application of a copper IUD can perforate completely the uterus and involve adjacent organs such as the bladder, small bowel, colon, rectum or appendix. Once the diagnosis is established, complete extraction must follow. We present a case report of a 33 year-old patient in which a copper IUD was placed in a medical office, three months after a third cesarean, without history of sepsis. Ninety days after placement, the patient complained of menstrual irregularities (opsomenhorrea) without any other symptoms. On physical examination with speculum, the IUD's guide strings were not visible; a transvaginal USG was performed without visualization of the IUD in the uterine cavity. An abdominal CAT scan showed the presence of the IUD outside the uterus. Hysteroscopy-laparoscopy was performed with transoperatory fluoroscopy, which revealed the copper IUD inside the yeyunum, a complete extraction followed with entero-entero anastomosis. This case will show that IUD placement is not innocuous and that adjacent organ damage must always be considered and resolved immediately.
Velázquez Velasco
Julio Rafael
JR
Centro Especializado para la Atención de la Mujer, Hospital Angeles Interlomas, México.
Vilchis Nava
Pablo
P
Nevarez Bernal
Roberto Armando
RA
Kably Ambe
Alberto
A
D000328:Adult; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D005548:Foreign-Body Migration; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007435:Intrauterine Devices, Copper / Q000009:adverse effects*; D007579:Jejunal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007583:Jejunum / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D010535:Laparoscopy; D011859:Radiography; D016896:Treatment Outcome; D014595:Uterine Perforation / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014599:Uterus / Q000293:injuries / Q000601:surgery