Ozdemir Hüseyin, Mahmutyazicioğlu Kamran, Tanriverdi H Alper, Gündoğdu Sadi, Savranlar Ahmet, Ozer Tülay
Department of Radiology, Zonguldak Karaelmas University, Faculty of Medicine, Kozlu 67600, Zonguldak, Turkey.
J Clin Ultrasound. 2004 Feb;32(2):91-4. doi: 10.1002/jcu.10228.
We present the case of a 37-year-old woman with a history of 2 consecutive insertions of intrauterine contraceptive devices (IUDs) 3 years before she was referred to us for sonographic evaluation of lower abdominal pain. The first of the IUDs was presumed to have been expelled spontaneously, and 3 months after insertion of the second device, the patient had begun experiencing lower abdominal pain. Medical treatment with antibiotics and spasmolytics had been unsuccessful. We performed transvaginal sonography, which revealed the presence of an IUD in the uterus and a 2-cm linear metallic echogenic area in the left ovary, believed to represent another IUD. Anteroposterior radiography confirmed that there were 2 IUDs in the pelvis, and CT demonstrated 1 IUD in the uterus and another in the left ovary. The patient underwent laparoscopic removal of the ovarian IUD and was discharged in good condition. To our knowledge, this is the first report of migration of an IUD to the ovary detected on transvaginal sonography. We recommend consideration of this possibility during evaluation of women with unexplained chronic pelvic pain.
我们报告一例37岁女性病例，该患者在因下腹部疼痛前来我们处接受超声检查的3年前，曾连续两次放置宫内节育器（IUD）。第一个IUD推测已自行排出，在第二个IUD置入3个月后，患者开始出现下腹部疼痛。使用抗生素和解痉药进行治疗均未成功。我们进行了经阴道超声检查，结果显示子宫内有一个IUD，左卵巢有一个2厘米的线性金属回声区，据信代表另一个IUD。前后位X线摄影证实盆腔内有2个IUD，CT显示子宫内有1个IUD，左卵巢内有另一个。患者接受了腹腔镜下卵巢IUD取出术，术后恢复良好出院。据我们所知，这是经阴道超声检查发现IUD迁移至卵巢的首例报告。我们建议在评估原因不明的慢性盆腔疼痛女性时考虑这种可能性。
