Migration of an intrauterine contraceptive device to the caecum : a case report

Abstract EN

The use of an intrauterine contraceptive device is safe in most of cases, but it is not free of complications.

One of the most dangerous complications is perforation of the uterine cavity by the intrauterine contraceptive device, and its migration to the abdominal cavity.

The case which we report here is about a 27 year old woman who presented to the hospital complaining of lower abdominal pain.

She had a history of intrauterine contraceptive device insertion six weeks following a caesarean section.

Uterine perforation was suspected by the intrauterine contraceptive device, so the patient was referred to King Hussein Medical Centre for further evaluation and management.

After full clinical examination, ultrasonographic and x-ray examination, the patient was diagnosed to have a missing device from the uterus.

The patient underwent laparoscopy which failed to locate the intrauterine contraceptive device.

Post-operatively the patient was advised to undergo laparatomy, but she refused and was lost to follow-up.

After ten months the patient presented to the clinic complaining of pelvic cramps and the decision was taken to perform a laparatomy.

Laparatomy was performed and revealed the intrauterine contraceptive device was impacted in the caecum; the surgeon opened the lumen and found the intrauterine contraceptive device within the wall of the caecum but not penetrating the lumen.

The intrauterine contraceptive device was removed and the bowel was closed in two layers.