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Levonorgestrel intrauterine system embedded within tubal ectopic pregnancy: a case report
Dorothy Makena1, Ingrid Gichere2, Khadija Warfa2
1Department of Obstetrics and Gynecology, Aga Khan University Hospital Nairobi, P.O. Box 30270-00100, Nairobi, Kenya. maksdot@gmail.com.
Background:
The presence of the levonorgestrel-releasing intrauterine system embedded within an ectopic pregnancy is a rare occurrence. Tubal migration of an intrauterine device is not well understood and has not been extensively studied in literature.
Case Presentation:
A 34-year-old African woman, para 1, gravida 2, presented with symptoms of ruptured ectopic pregnancy. She underwent a laparoscopy where a ruptured left ectopic pregnancy was found with a levonorgestrel-releasing intrauterine system inserted 2 years prior embedded within the tube. A left salpingectomy was performed with removal of the levonorgestrel-releasing intrauterine system. The patient recovered well and proceeded to have an intrauterine pregnancy 3 months later.
Conclusion:
Migration of the levonorgestrel-releasing intrauterine system into the fallopian tube is a rare occurrence that is not well understood. In the case presented, levonorgestrel-releasing intrauterine system was found embedded within the fimbrial end of the left fallopian tube, which had a ruptured ectopic pregnancy. Surgical treatment with laparoscopy is recommended for intraabdominal intrauterine device to prevent complications.
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