2243 Abdominal Pain Born From Migrating IUD to the Liver

Abstract

INTRODUCTION: The use of intrauterine devices are a core of contraception practiced globally. There are several different types and brands that are FDA Approved for use in the United States. The advantages include their length of efficacy, one cost, and safe for breastfeeding. The risks of using IUDs include infection and migration. These risks have been as high as 3% but more consistently at one to two percent. Usual mechanisms for migration include erosion through uterine tissue or expulsion from vaginal canal. Once migrated the device is removed and another is placed as efficacy drops. CASE DESCRIPTION/METHODS: Patient is a 43-year-old female Hispanic American who presented to the hospital with complaints of generalized abdominal pain and low back pain for one year. The patient has no past medical history and does not take any medication besides ibuprophen for minor aches and pains. The patient has a surgical history of copper IUD placed five years prior. The patient mentions at a recent appointment with her primary care doctor her “liver tests” were “a tad elevated.” The patient has no family history of cancer or gastrointestinal history. Labs were performed and were WNL other than moderately elevated transaminases. Imaging demonstrating the patient’s intrauterine device had migrated to the anterior portion of the liver. DISCUSSION: There have been less than three cases including this one where an IUD migrated to the liver. The migration of the copper IUD was causing the transaminitis and general abdominal pain. This Case was chosen because it demonstrates a complication that is less than one percent. There have been very limited cases of an IUD migrating to the liver and even lower causing transaminitis. The mechanism of the migration in this case is unknown and thus makes this case very unusual. The proposed mechanism is erosion through the uterus and migration to the anterior portion of the liver.