Presentation
Left sided pelvic cramping after intrauterine device (IUD) placement in outpatient OBGYN clinic.
Patient Data
Transvaginal pelvic ultrasound
Transvaginal pelvic ultrasound images obtained of the uterus demonstrate an absence of IUD arms in the uterine fundus. With scrolling in the craniocaudad direction, there is symmetric posterior acoustic shadowing in the posterolateral aspects of the myometrium compatible with inadvertent placement of IUD arms in the myometrium.
These foci of shadowing can be traced back to the endometrial canal revealing a low lying body of the intrauterine device in the inferior uterus and cervical canal.
Case Discussion
Imaging findings of this case were discussed via telephone with ordering outpatient OBGYN. The patient was contacted and returned to the clinic where her intrauterine device was subsequently removed, resulting in resolution of her pain.
This case demonstrates that arms of intrauterine contraceptive device can often be more apparent from the posterior acoustic shadowing they create.
Imaging findings are compatible with myometrial arm placement demonstrating IUD arms extending outside of the endometrial cavity, and subsequent removal resulted in complete resolution of patient pain.