Abstract:
BACKGROUND: Loss of Intra Uterine Device (IUD) following silent perforation of the uterus either during or after IUD insertion is an uncommon finding due to a lack of immediate follow-up. We report a rare case in which uterine perforation following the migration of IUD to the right fallopian tube without visceral injury. The patient presented with lower abdominal pain and pain during sex for one year since IUD insertion. On examination, we noted tenderness on the right suprapubic region and on speculum examination, no IUD thread was seen. A radiological pelvic examination showed an empty uterus without an IUD. Laparotomy and retrieval of migrated IUD was done followed by repair of perforated uterus.
CONCLUSIONS: Migrated IUD with silent uterine perforation without visceral injury is a distressing clinical condition both to the patient and the clinician. This case is reported to increase awareness in doing immediate vaginal examination and pelvic ultrasound post-IUD insertion.
摘要:
背景:宫内节育器插入期间或之后子宫无症状穿孔后,由于缺乏立即随访,宫内节育器(IUD)的丢失是一个罕见的发现。我们报告了一种罕见的情况,其中宫内节育器向右输卵管迁移后子宫穿孔而没有内脏损伤。患者在插入宫内节育器后一年内出现下腹痛和性交疼痛。在检查中,我们注意到右侧耻骨上区域和窥器检查有压痛,没有看到宫内节育器螺纹。放射盆腔检查显示子宫空,没有宫内节育器。进行剖腹手术并取出迁移的宫内节育器,然后修复子宫穿孔。
结论:宫内节育器伴无症状子宫穿孔而无内脏损伤是一种困扰患者和临床医生的临床疾病。据报道,该病例可提高IUD插入后立即进行阴道检查和盆腔超声检查的意识。