Asymptomatic Migration of Intrauterine Device into the Abdominal Cavity

Abstract

ABSTRACT The Intrauterine Device (IUD) is one of the most used and effective contraceptive means worldwide due to its anti-conceptual and anti-nesting action. Although IUD use offers the benefits of being affordable, long lasting, highly effective, and reversible. However, like any foreign body, it can expose to certain complications, sometimes, with very serious consequences. Migration is the rarest but most feared complication. The frequency of uterine perforation ranges from 0.05 to 13 per 1000 insertions. It can be announced by pelvic pain, and in the majority of cases reported; this accident does not lead to major complications and remains clinically silent. The clinical presentation varies depending on the final ectopic site of the device. We report the case of an IUD migration into the peritoneal cavity 10 years after its insertion in a 41-year-old patient whose only complaint was epigastric pain. The clinical examination did not reveal lower abdominal tenderness. Apart from a lipase rate, which was around ten times the normal level, other ordinary blood tests did not show any abnormalities. The diagnosis was made fortuitously based on the subsequent CT scan findings that were part of the routine staging of the acute lithiasic pancreatitis, the underlying cause of the described pain. Acute pancreatitis was staged B and the patient had a successful surgical retrieval of the IUD with a good outcome.

Keywords

• complication
• laparoscopy
• uterine perforation