Migration of a Hodge pessary into the abdominal cavity; a rare complications.
A 62-year old para 4 with a history of a radical hysterectomy followed by radiotherapy for endometrial carcinoma was seen shortly after insertion of a pessary for a total vault prolapse. On follow-up the pessary couldn't be retrieved. An abdominal X-ray revealed the pessary in the abdominal cavity and it had to be removed by means of a laparotomy. Fistula and defects have been reported both in longstanding pessary use and as long-term complication in radical surgery with radiotherapy. In view of potential - though rare - serious complications, adequate follow-up in pessary use is therefore mandatory. Adequate diagnostic investigations are essential in deciding on an appropriate approach for rare cases like these.
Lim
Boon K
BK
Department of Obstetrics & Gynecology, University Malaya Medical Center, Kuala Lumpur, Malaysia. boonklim@hotmail.com
Collaris
Ronald R J
RR
D034841:Abdominal Cavity / Q000000981:diagnostic imaging; D016889:Endometrial Neoplasms / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D010570:Pessaries; D014057:Tomography, X-Ray Computed; D014596:Uterine Prolapse / Q000628:therapy