title: [A more and more painful intrauterine device… where it is not enough to see the wires to exclude malposition!].
abstract: We report a case of a 30-year-old woman with an intrauterine device (IUD) improperly inserted deep within the myometrium, with a muscularis layer injury of the recto-sigmoid colon resulting of a uterine perforation and presented as abdomino-pelvic pain and dyspareunia. The ultrasonographic control of the IUD after the insertion (performed seven months before) was not checked. Cervical examination showed the strings of the IUD. The ultrasonographic exploration identified an intra-myometrial IUD with fundus perforation of the uterus. A laparoscopic exploration permitting the removal of the IUD revealed an insertion through the bowel wall. The lessons to draw of about this case report are discussed through a brief review of the literature.
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France. Electronic address: enohuz@yahoo.fr.
authors.forename: E
authors.initials: E
authors.lastname: Nohuz
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
authors.forename: R
authors.initials: R
authors.lastname: Battista
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
authors.forename: S
authors.initials: S
authors.lastname: Tamburro
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
authors.forename: M
authors.initials: M
authors.lastname: Leonenko
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
authors.forename: S
authors.initials: S
authors.lastname: Bayeh
authors.affiliation: Service de chirurgie générale et digestive, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
authors.forename: J
authors.initials: J
authors.lastname: Varga
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France; Service de gynécologie-obstétrique et biologie de la reproduction, CHU Estaing, 1, place Lucie Aubrac, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: G
authors.initials: G
authors.lastname: Mage
mesh_terms: D015746:Abdominal Pain; D000328:Adult; D012809:Colon, Sigmoid / Q000293:injuries; D004414:Dyspareunia; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects*; D010535:Laparoscopy; D009215:Myometrium; D017699:Pelvic Pain; D012007:Rectum / Q000293:injuries; D014463:Ultrasonography; D014595:Uterine Perforation / Q000000981:diagnostic imaging / Q000209:etiology*