Peritoneal migration of IUCD

Case contributed by Dr Ammar Haouimi

Presentation

Chronic pelvic pain.

Patient Data

Age: 25 years
Gender: Female

Subseptate uterus. The intrauterine contraceptive device (IUCD) is located outside of the uterine cavity in the Douglas pouch adjacent to the rectal wall with mild surrounding fat stranding and minimal effusion. No adjacent intraluminal gas. No signs of acute uterine perforation.

Annotated image

Partial septum involving the upper uterine canal, not extending to the cervix (common cervix) with mildly concave surface of the fundus, and acute angle between the uterine cavities (46° in this case).

Case Discussion

CT features of a peritoneal migration in the Douglas pouch of an IUCD inserted 2 years ago in a patient with a subseptate uterus with no signs of acute uterine or rectal perforation.

CT is the modality of choice to detect the complications that could be due to the migration of an IUD such as hollow visceral perforation, abscess formation, pelvic inflammatory disease.

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