IUCD related uterine perforation
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.
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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.
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.