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Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
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Missing IUD Despite Threads at the Cervix.

Andrew L Atkinson1, Jonathan D Baum1

  • 1Department of Obstetrics and Gynecology, Jersey Shore University Medical Center, 1945 Route 33, Neptune, NJ 07753, USA.

Case Reports in Obstetrics and Gynecology
|September 25, 2014
PubMed
Summary
This summary is machine-generated.

Intrauterine devices (IUDs) are popular reversible contraceptives. This case highlights a rare complication where an IUD perforated the uterus, migrated intraperitoneally, and required laparoscopic removal after imaging provided conflicting results.

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Area of Science:

  • Gynecology
  • Minimally Invasive Surgery
  • Medical Imaging

Background:

  • Intrauterine devices (IUDs) are a leading method of long-term reversible contraception globally.
  • While generally safe, serious complications like uterine perforation and IUD migration can occur.
  • Confirmation of IUD placement typically involves physician visualization or palpation of retrieval threads at the cervical os.

Purpose of the Study:

  • To report a rare case of a perforated, intraperitoneal intrauterine device (IUD).
  • To illustrate the diagnostic challenges and successful surgical management of a migrated IUD.
  • To emphasize the importance of advanced imaging and laparoscopic intervention in complex IUD cases.

Main Methods:

  • A case presentation of a patient with a perforated, intraperitoneal IUD.
  • Review of diagnostic modalities including pelvic ultrasound, hysteroscopy, cystoscopy, and MRI.
  • Surgical intervention via laparoscopy for IUD removal.

Main Results:

  • The IUD had perforated the uterus and migrated into the peritoneal cavity.
  • Retrieval threads were present at the cervical os, initially suggesting correct placement.
  • Imaging studies yielded conflicting results regarding the IUD's exact location.
  • Office-based removal attempts were unsuccessful.

Conclusions:

  • Uterine perforation and intraperitoneal migration of an IUD is a rare but serious complication.
  • Diagnostic imaging can provide conflicting information in cases of migrated IUDs.
  • Laparoscopy is an effective method for the removal of a perforated and migrated IUD.