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Rectal strictures associated with the intra-uterine contraceptive device
The British Journal of Surgery
|March 1, 1982
Summary
Intrauterine contraceptive device (IUCD) use can cause mid-rectal strictures due to pelvic cellulitis, often requiring complex surgery. Upper rectal strictures from gynecological sepsis are typically easier to manage.
Area of Science:
- Gastroenterology
- Gynecology
- Surgical Pathology
Background:
- Pelvic cellulitis from intrauterine device (IUD) use can lead to severe rectal strictures.
- Intraperitoneal sepsis of gynecological origin, such as pyosalpinx, commonly causes upper rectal strictures.
Observation:
- Two cases of mid-rectal strictures following extensive pelvic cellulitis from IUD use are presented.
- These strictures were dense, circumferential, and extrarectal, resisting conservative treatment.
- A case of upper rectal stricture from pyosalpinx is contrasted.
Findings:
- Mid-rectal strictures from IUD-associated cellulitis proved difficult to treat, necessitating corrective resection.
- Upper rectal strictures, while potentially severe, were more amenable to management by addressing the infection source.
- Anatomical differences likely explain the distinct pathologies and management challenges between mid-rectal and upper rectal strictures.
Implications:
- Understanding anatomical factors is crucial for managing rectal strictures resulting from pelvic inflammation.
- Differentiation between IUD-related and gynecological sepsis-related strictures impacts treatment strategies.
- Further research into preventing and treating severe IUD-induced rectal complications is warranted.