2469 Perforated Copper-T Causing an Ovarian Abscess: The First Reported Case

Abstract

Video Objective To demonstrate laparoscopic retrieval of a rare case of Copper-T migration causing ovarian abscess. Setting A 34 year old Para4 Living4, who underwent a seemingly uneventful Copper-T insertion. She presented at follow up with lower abdominal pain for two months, and fever. Ultrasound showed an empty uterine cavity with Copper-T seen in the right adnexal region. Interventions She underwent laparoscopy proceed. At laparoscopy, the Copper-T was found to be embedded in a right tubo-ovarian mass which was adherent to the pelvic side wall. Ovary was friable, with abscess draining ∼5cc of purulent fluid. The Copper-T was dissected free of the T-O mass. Ureter was dissected free, and integrity ensured. Bilateral salpingectomy and thorough lavage was done. Patient was covered with broad spectrum antibiotics. Post-operative period was uneventful. Conclusion Perforation and migration of IUD can rarely lead to ovarian abscess. Diagnosis and retrieval should be prompt, with appropriate antibiotic cover. Laparoscopic retrieval is a feasible method for IUD retrieval. In-depth knowledge of laparoscopic surgical anatomy is essential in such cases.