A Forgotten Migrated Intrauterine Contraceptive Device Is Not Always Innocent: A Case Report

Ranjeet Brar,Sudeendra Doddi,Prakash Sinha,Anand Ramasamy

doi:10.1155/2010/740642

Abstract

The incidence of transuterine perforation and migration of intrauterine contraceptive devices (IUCDs) into the abdominal cavity has been estimated at less than 0.1%. It has been suggested that intraperitoneal IUCD have low morbidity and may be left in situ. We report the first case of closed loop small bowel obstruction due to migration of a “Saf-T-Coil” IUCD into the abdominal cavity, where it became embedded in the omentum and ultimately, 31 years after deployment, coiled both arms around a loop of ileum. This late complication underlines the dangers of intra-abdominal foreign bodies, even when chemically and biologically inert.

Highlights

Her past surgical history consisted of open appendicectomy at 21 years of age, termination of pregnancy at 31 years, and a laparoscopic tubal ligation at the age of 38. (She underwent menopause at the age of 54.)
The migratory “Saf-T-Coil” Intrauterine contraceptive devices (IUCDs), fitted some 31 years earlier, had become embedded in the omentum, and each of the two “arms” of the coil had encircled the lumen of a segment of mid ileum, giving rise to a closed loop obstruction
Colonic obstruction has been described in the context of severe pelvic inflammatory disease (PID) with prolonged IUCD use [4, 5]

Summary

Introduction

Her past surgical history consisted of open appendicectomy at 21 years of age, termination of pregnancy at 31 years, and a laparoscopic tubal ligation at the age of 38. (She underwent menopause at the age of 54.). The patient’s obstructive symptoms were correlated with radiological findings and an apparently ectopic IUCD was noted. This demonstrated obstruction of the small bowel in association with the migratory IUCD, and the patient underwent laparotomy to relieve the obstruction. The migratory “Saf-T-Coil” IUCD, fitted some 31 years earlier, had become embedded in the omentum, and each of the two “arms” of the coil had encircled the lumen of a segment of mid ileum, giving rise to a closed loop obstruction.

Results

Conclusion