Migrated IUCD

Case contributed by Abeer Ahmed Alhelali

Presentation

Lower abdominal pain for the last few months.

Patient Data

Age: 25 years
Gender: Female
ultrasound

Anteverted uterus with no intrauterine contraceptive device noted.
 

x-ray

IUCD seen at the level of S2 -3 along the midline suggesting Intraabdominal migration.

ct

CT findings reveal two supraumbilical ventral abdominal wall hernias, through which mesenteric fat and omentum are herniating. Incidental finding of a small splenic cyst.

There is the presence of a migrated IUCD, which is seen lying anterior to the uterus.

Case Discussion

IUCD Intra-abdominal migration is a rare complication of IUCD insertion in which the device will be freely floating in the abdomen or pelvis or encased in adhesions. It is associated with large fibroids or the post-partum uterus.

Ultrasound shows normal endometrial cavity with no hyperechoic linear structure within it. X-ray shows IUCD lateral to the midline or away from expected uterus site.

Treatment depends on the degree of perforation and if it is associated with complications like intestinal obstruction, infertility or sepsis.

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