Abstract
We report a case of laparoscopic removal of migrated IUCD to the sigmoid colon. Computed tomography (CT) precisely located the migrated device embedded in the sigmoid colon. After failure of endoscopic attempt to remove the device, laparoscopy was then performed. On initial laparoscopic examination no adhesions were found, the uterus, ovaries & tubes were normal in appearance, however a small bud was identified on the anterior surface of the descending branch of the sigmoid colon. This bud was related to one arm of the T shaped IUCD in fluoroscopy. During dissection around the bud fortunately one arm of the device was seen and then the IUCD was easily extracted, then separate stitches were done to suture the opening of the colon. Postoperative outcomes were uneventful.
Highlights
Migration of intrauterine contraceptive device (IUCD) to adjacent organs is rare but the most serious complication
Case presentation: We report a case of laparoscopic removal of migrated IUCD to the sigmoid colon
On initial laparoscopic examination no adhesions were found, the uterus, ovaries & tubes were normal in appearance, a small bud was identified on the anterior surface of the descending branch of the sigmoid colon
Summary
Intrauterine contraceptive Device (IUCD) widely used since 1965 because of their safety and effectiveness [1]. Retrieval in such situation depends on the location of the migrated intrauterine device and evolves endoscopy, laparoscopy or sometimes (if required) laparotomy. Diagnosis of IUCD drop was considered, and the patient has never consulted. The diagnosis of IUCD migration was suspected and computed tomography was ordered wish showed migration of the T copper device totally to the sigmoid colon (Figure 2). Terior surface of the descending branch of the sigmoid colon (Figure 3a) This bud is related to one arm of the T shaped IUCD in fluoroscopy (Figure 4). During dissection around the bud one arm of the device was seen (Figure 3b) and the IUCD was extracted, separate stitches were done to suture the opening (Figure 3c). There was no recurrence of symptoms on subsequent follow-up
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