Ohana E, Sheiner E, Leron E, Mazor M
Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Eur J Obstet Gynecol Reprod Biol. 2000 Feb;88(2):129-31. doi: 10.1016/s0301-2115(99)00142-6.
Perforation of the uterus by an intrauterine contraceptive device (IUD) is a rare, and serious complication, occurring in 1/350 to 1/2500 insertions. Perforation by IUDs can involve several neighboring organs such as the bladder and rectosigmoid. We report two cases of IUD perforations involving the appendix, both inserted during lactation. The first case is an asymptomatic patient in early pregnancy and the second is a woman whose original presentation was chronic lower abdominal pain. The presence of copper in the abdominal cavity can lead to adhesion formation and subsequent abdominal pain, bowel obstruction or infertility. Thus, we believe that when an IUD is located in the abdominal cavity it should be removed even in an asymptomatic patient. In addition, these cases might suggest postponing the use of this contraceptive method in lactating women.
宫内节育器（IUD）导致子宫穿孔是一种罕见且严重的并发症，发生率为1/350至1/2500次放置。IUD穿孔可累及多个邻近器官，如膀胱和直肠乙状结肠。我们报告两例IUD穿孔累及阑尾的病例，均在哺乳期放置。第一例是早期妊娠的无症状患者，第二例是最初表现为慢性下腹痛的女性。腹腔内铜的存在可导致粘连形成，继而引起腹痛、肠梗阻或不孕。因此，我们认为，当IUD位于腹腔内时，即使是无症状患者也应取出。此外，这些病例可能提示哺乳期妇女应推迟使用这种避孕方法。
