Incidental finding of an intrauterine device in the sigmoid colon

Translocation of an intrauterine device (IUD) to the sigmoid colon lumen is an extremely rare presentation of an ectopic IUD that usually results in fever and gastrointestinal symptoms. We report the exceptional case of an asymptomatic IUD translocation to the sigmoid colon lumen secondary to uterine perforation.

A CT-scan was carried out during the follow-up of a 53-year-old woman with a metastatic epidermoid carcinoma of the tongue evolving over the previous eight years. It incidentally revealed the presence of an IUD in the sigmoid colon lumen. The patient being completely asymptomatic and at the terminal stage of her disease, removal of the device by means of a surgical or endoscopic procedure was not attempted. The patient died four months later due to lung cancer; during that period of time the IUD located in the colon remained asymptomatic.

Asymptomatic migration of IUD to the sigmoid colon lumen can occur. Except when the patient's condition does not allow it, as in the case reported, removal of the IUD is indicated because of the risk of fistula formation and colon perforation with a high ensuing morbidity. This case report highlights the need for follow-up of patients wearing an IUD.