title: A new endoscopic method of retrieval of a migrated and transmurally embedded intrauterine contraceptive device in the rectum.
abstract: A 45-year-old lady presented with left lower quadrant abdominal pain and hematochezia of 1 month duration. She had Copper-T, an intrauterine contraceptive device (IUCD) inserted in the immediate post-partum period 25 years ago elsewhere and was lost to follow up. CT abdomen done 2 weeks earlier before reporting to us revealed a migrated and translocated IUCD embedded in the right lateral wall of the rectum. On colonoscopy, an area of friable mucosal nodule was noticed in the right lateral wall 10 cm from the anal verge but the IUCD was not visible intraluminally. Fluoroscopy showed the horizontal limb lying in close approximation with the rectal wall and the vertical limb of the IUCD embedded at the site of mucosal nodule in the rectum. After a careful endoscopic mucosotomy, the vertical limb was exposed and the Copper-T in its entirety was retrieved using a polypectomy snare. The mucosal defect was closed with hemoclips. She became asymptomatic after the procedure.
authors: Medindia Hospitals, 83, Valluvar Kottam High Road, Nungambakkam, Chennai, 600 034, India. tscmedindia@yahoo.com.
authors: T S
authors: TS
authors: Chandrasekar
authors: Medindia Hospitals, 83, Valluvar Kottam High Road, Nungambakkam, Chennai, 600 034, India.
authors: B J
authors: BJ
authors: Gokul
authors: Medindia Hospitals, 83, Valluvar Kottam High Road, Nungambakkam, Chennai, 600 034, India.
authors: K Raja
authors: KR
authors: Yogesh
authors: Medindia Hospitals, 83, Valluvar Kottam High Road, Nungambakkam, Chennai, 600 034, India.
authors: S
authors: S
authors: Sathiamoorthy
authors: Medindia Hospitals, 83, Valluvar Kottam High Road, Nungambakkam, Chennai, 600 034, India.
authors: M S
authors: MS
authors: Prasad
authors: Medindia Hospitals, 83, Valluvar Kottam High Road, Nungambakkam, Chennai, 600 034, India.
authors: T C
authors: TC
authors: Viveksandeep
authors: Medindia Hospitals, 83, Valluvar Kottam High Road, Nungambakkam, Chennai, 600 034, India.
authors: M Ahmed
authors: MA
authors: Ali
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000601:surgery*; D005548:Foreign-Body Migration / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects*; D008875:Middle Aged; D012007:Rectum / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Copper-T migration; Endoscopic retrieval; Hematochezia; Intrauterine contraceptive device; Mucosotomy