Peritoneal migration of IUCD

Case contributed by Ian Bickle

Presentation

Female of child bearing age with several months of right sided abdominal pain. Long term use of IUCD.

Patient Data

Age: 35 years
Gender: Female
x-ray

Two IUCD's projected over the pelvis, at different angulations.

The right sided IUCD is in a high position provided the patient does not have a history of uterine enlargement.

IUCD in the endometrial cavity.

An additional IUCD lies some distance from the uterus lying anteriorly in the lower right side of the pelvis anterior to the small bowel in an extra-uterine in position.

No surrounding collection.

Case Discussion

This case demonstrates a rare complication of the use of IUCD's - even more so for the fact the patient has synchronous correctly and incorrectly sited IUCD's.

A new IUCD must have been inserted after the prior one was 'lost' .  Clinically no strings evident per vaginum and not visible on ultrasound.  The assumption being it had been lost per vaginum, not that it had undergone perforated the uterine wall and migrated into the peritoneal space.

 

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