Korean J Gastroenterol.  2021 Jul;78(1):48-52. 10.4166/kjg.2021.041.

Incomplete Removal of an Intrauterine Device Perforating the Sigmoid Colon

• Lee J
• Oh JH
• Kim J
• Lim CH
• Jung SH

• KMID: 2518752
• DOI: http://doi.org/10.4166/kjg.2021.041

Abstract

Intrauterine devices (IUDs) are widely used for contraception in South Korea. However, several complications of IUDs have been reported, including inflammation, obstruction, perforation, and fistula. IUD perforation is the rarest of these complications but is also severe. Migrated IUDs can be retrieved through endoscopy, laparoscopy, or laparotomy. Presented below is an atypical case of an IUD perforating the sigmoid colon, which could not be removed endoscopically, and was subsequently incompletely removed through laparoscopic surgery. The present case underlines the importance of appropriate diagnosis and treatment approach in the management of IUD perforation.

Keyword

Intrauterine devices; Colon; sigmoid; Intestinal perforation

Figure

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  Fig. 1 Colonoscopy findings: (A) a yellow tube penetrating sigmoid colon with edematous mucosal change and pus, (B) Intrauterine device (IUD) had penetrated the lumen of the distal sigmoid colon and was surrounded by granulation tissue, (C) attempts to retrieve the IUD using biopsy forceps failed because of severe adhesions, (D) the missing part of the IUD was absent from the colon lumen.

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  Fig. 2 Abdominal X-ray findings: (A) an intrauterine device (IUD) in the pelvis (arrowhead), (B) part of the IUD remained in the right lower abdomen (arrowhead).

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  Fig. 3 Abdominal computed tomography scan findings: (A, B) 4-cm intrauterine device penetrating the wall of the sigmoid colon (arrowhead).

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  Fig. 4 Laparoscopy findings: (A) intrauterine device (IUD) was retrieved by the grasper, (B) 1-cm right arm of the IUD was not retrieved.

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