Colorectal penetration by two intrauterine devices

Area of Science:

• Gastroenterology
• Radiology
• Gynecology

Background:

• Colorectal cancer screening programs aim to detect precancerous and cancerous lesions.
• Foreign body ingestion or migration is a rare but potential complication in the gastrointestinal tract.

Observation:

• During a colonoscopy for a positive fecal occult blood test, two metallic foreign bodies were identified in the transverse colon and rectal wall.
• Computed tomography confirmed the T-shaped, metallic foreign bodies resembled intrauterine devices (IUDs) penetrating the intestinal wall.

Findings:

• The patient reported a history of a lost IUD 35 years prior, followed by a second IUD insertion.
• The imaging findings indicated chronic perforation and migration of the IUDs through the intestinal wall.

Implications:

• This case highlights the potential for long-term complications from retained intrauterine devices, including gastrointestinal migration.
• It underscores the importance of thorough patient history and advanced imaging in diagnosing unusual gastrointestinal foreign bodies.
• While asymptomatic, the presence of perforated IUDs necessitates consideration for management strategies.