Thorn in my Side - A Case of Entrapped, Intra-uterine Foreign Body and Delayed, Atypical Pelvic Inflammatory Disease

Abstract

Uterine foreign bodies are a rare, but important cause of infertility and pelvic pain. Due to their relative scarcity, the diagnosis may be either missed or simply not considered as contributory to aetiology when patients present with symptoms. We report the case of a 42-year-old woman diagnosed with Atypical Pelvic Inflammatory Disease (APID). She presented with lower abdominal pain, vaginal discharge and inflammatory markers consistent with acute infection. Paradoxically, diagnostic imaging revealed an unsuspected intrauterine foreign body. The significance of this to the presenting complaint was initially uncertain however conservative management with antibiotics alone was sufficient to allow complete recovery. Later, the patient consented to operative hysteroscopy which identified and removed the object which was shown by histology to be a residual bone fragment derived most probably, from retained products of conception. The patient was noted to have had a surgical termination of pregnancy 5 years prior.