Small bowel obstruction caused by intrauterine device infection

Area of Science:

• Gastroenterology
• Gynecology
• Infectious Disease

Background:

• Lower abdominal pain in women of reproductive age can indicate serious conditions.
• Pelvic inflammatory disease is a known complication of intrauterine devices (IUDs).

Purpose of the Study:

• To report a rare case of small bowel obstruction (SBO) secondary to pelvic peritonitis caused by an infected intrauterine device (IUD).
• To highlight the importance of considering gynecological causes in women presenting with lower abdominal pain and signs of SBO.

Main Methods:

• A case report of a 39-year-old woman presenting with symptoms suggestive of acute enteritis, progressing to SBO.
• Diagnostic workup included abdominal radiography, laboratory tests (WBC, CRP), contrast-enhanced computed tomography (CT), and gynecological examination.
• Treatment involved conservative management including fasting, parenteral nutrition, antibiotics, and ileus tube insertion.

Main Results:

• The patient developed SBO with signs of pelvic peritonitis.
• An infected, pus-filled intrauterine device (IUD) was identified as the cause.
• Conservative management successfully resolved the SBO in 12 days.

Conclusions:

• Intrauterine device (IUD) infection can lead to severe complications like pelvic peritonitis and small bowel obstruction (SBO).
• Clinicians should maintain a high index of suspicion for gynecological pathology in women of reproductive age presenting with lower abdominal pain and SBO.
• Early diagnosis and appropriate management are crucial for favorable outcomes in such cases.