IUCD related uterine perforation

Case contributed by Wouter Kroon

Presentation

Patient presented with right sided flank pain. She had a history of renal stones, so an unenhanced CT scan was performed for evaluation of renal stones.

Patient Data

Age: 55
Gender: Female

Unenhanced CT

Modality: CT

Unenhanced abdominal CT shows an intrauterine device, which has migrated from the lumen of the uterus through the uteral wall and part of the device is now intra-abdominally located. No signs of fat infiltration, free fluid or air in the abdomen. So, no signs of further complications.

Case Discussion

Uterine perforation is a serious complication. It occurs in roughly 1/1000 cases. There are not many risk factors documented, but lactating and having had a baby within 6 months prior to placement are risk factors. The degree of malpositioning of an intrauterine device can range from embedment in the myometrium to complete perforation.1

Malpositioning of the IUD can be assessed by ultrasound, but CT can be used to exclude other causes, to evaluate the precise location and to assess possible complications that have occurred.

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Case Information

rID: 29564
Case created: 5th Jun 2014
Last edited: 6th Jul 2016
System: Gynaecology
Inclusion in quiz mode: Included

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