Intrauterine device copper wire sheath fracture

Case contributed by Dr Maulik S Patel

Presentation

Intrauterine device placement about 10 years back. Referred by the gynecologist to rule out a fractured intrauterine device.

Patient Data

Age: 35 years
Gender: Female

There is a discontinuity in the echogenic line of the vertical stem of the intrauterine device. There is a posterior acoustic shadow with or without the presence of the echogenic line of vertical stem. The horizontal arm is normal. There is no endometrial collection.

The first photo is a retrieved IUD showing a breach in the copper sheath with an intact core. The second photo shows a normal IUD for comparison.

In vitro IUD ultrasound

Ultrasound

The long axis image shows the stem of the intrauterine device as two parallel thin faintly echogenic lines. There is highly echogenic material on the surface of the underlying stem which is copper.

There is a breach in the continuity of the copper sheath in the vertical stem. The stem is intact.

Case Discussion

A patient was referred for an ultrasound for the intrauterine device evaluation. Ultrasound shows a discontinuity in echogenicity in the vertical stem. However, the posterior acoustic shadow was present with or without echogenicity favoring continuity of vertical stem. The IUD was retrieved and showed a breach in the copper sheath with the intact stem.

Intrauterine device photo courtesy: Treating Dr. Snehal V. Patel

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