DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20195026

Migration of intra caesarean intrauterine device to sigmoid colon: a case report

Jharna Behura, Sanjiva Kumar

Abstract


Post-partum intrauterine contraceptive device inserted during caesarean section provides long acting reversible contraception to women soon after birth. It is now well accepted for its safety and efficacy. Uterine perforation, which is one of the most serious complication of PPIUCD has rarely been reported following intracaesarean insertion. The thick uterine wall and placement under direct vision helps prevent perforation. However, migration of IUCD to peritoneal cavity, causing perforation of several adjacent organs can occur due to improper closure of the uterine incision. Migration to sigmoid colon is an extremely rare complication. Authors present the case of a 29-year-old woman who had a Cu T 380 A insertion during Caesarean section. After 12 months of insertion, the patient suffered abdominal pain gradually increasing in intensity and frequent episodes of bleeding per rectum. Laparoscopic exploration revealed IUCD perforating the sigmoid colon completely and adhesions of bowel loops to the sigmoid colon. Extraction using laparoscopic method by gently pulling the threads was unsuccessful and the patient was managed by laparotomy.


Keywords


Laparoscopy, Laparotomy, Migrated intrauterine contraceptive device, Postpartum intrauterine contraceptive device, Sigmoid perforation

Full Text:

PDF

References


Post-partum IUCD reference manual; Family Planing Division. Ministry of Health and Family Welfare, Government of India. 2010:1-3.

Singal S, Bharti R, Dewan R. Clinical outcome of postplacental Copper T 380A insertion in women delivering by caesarean section. J Clin Diagnos Res. 2014;8(9):OC01-4.

Mishra N, Dalal N, Joshi V. Intrauterine Device Insertion during Caesarean Section- A boon for Rural Women. IOSR-JDMS. 2013;8(3):21-3.

Levi E, Cantillo E, Ades V, Banks E, Murthy A. Immediate postplacental IUD insertion at cesarean delivery: a prospective cohort study. Contracept. 2012;86(2):102-5.

Takahashi H, Puttler KM, Hong C, Ayzengart AL. Sigmoid colon penetration by an intrauterine device: a case report and literature review. Mil Med. 2014;179(1):127-9.

Gill RS, Mok D, Hudson M, Shi X, Birch DW, Karmali S. Laparoscopic removal of an intra-abdominal intrauterine device: case and systematic review. Contracept. 2012;85(1):15-8.

Chen CP, Hsu TC, Wang W. Ileal penetration by a multiload-Cu 375® intrauterine contraceptive device: a case report with review of the literature. Contracept. 1998;58(5):295-304.

Arslan A, Kanat-Pektas M, Yesilyurt H, Bilge U. Colon penetration by a copper intrauterine device: a case report with literature review. Arch Gynecol Obstet. 2009;279(3):395-7.

Zakin D, Stern WZ, Rosenblatt R. Complete and partial uterine perforation and embedding following insertion of intrauterine deives. I. Classification, complications, mechanism, incidence, and missing string. Obstet Gynecol Surv. 1981;36(7):335.

Halder A, Sowmya MS, Gayen A, Bhattacharya P, Mukherjee S, Datta S. A prospective study to evaluate vaginal insertion and intra-cesarean insertion of post-partum intrauterine contraceptive device. J Obstet and Gynecol India. 2016;66(1):35-41.

Rahnemai-Azar AA, Apfel T, Naghshizadian R, Cosgrove JM, Farkas DT. Laparoscopic removal of migrated intrauterine device embedded in intestine. J Soc Laparoendo Surg. 2014;18(3).