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乙状结肠内意外发现宫内节育器。

Incidental finding of an intrauterine device in the sigmoid colon.

作者信息

Sentilhes Loïc, Lefebvre-Lacoeuille Céline, Poilblanc Mathieu, Descamps Philippe

机构信息

Department of Obstetrics and Gynaecology, Angers University Hospital, Angers, France.

出版信息

Eur J Contracept Reprod Health Care. 2008 Jun;13(2):212-4. doi: 10.1080/13625180801892868.

Abstract

BACKGROUND

Translocation of an intrauterine device (IUD) to the sigmoid colon lumen is an extremely rare presentation of an ectopic IUD that usually results in fever and gastrointestinal symptoms. We report the exceptional case of an asymptomatic IUD translocation to the sigmoid colon lumen secondary to uterine perforation.

CASE REPORT

A CT-scan was carried out during the follow-up of a 53-year-old woman with a metastatic epidermoid carcinoma of the tongue evolving over the previous eight years. It incidentally revealed the presence of an IUD in the sigmoid colon lumen. The patient being completely asymptomatic and at the terminal stage of her disease, removal of the device by means of a surgical or endoscopic procedure was not attempted. The patient died four months later due to lung cancer; during that period of time the IUD located in the colon remained asymptomatic.

CONCLUSION

Asymptomatic migration of IUD to the sigmoid colon lumen can occur. Except when the patient's condition does not allow it, as in the case reported, removal of the IUD is indicated because of the risk of fistula formation and colon perforation with a high ensuing morbidity. This case report highlights the need for follow-up of patients wearing an IUD.

摘要

背景

宫内节育器(IUD)移位至乙状结肠腔是一种极为罕见的异位IUD表现,通常会导致发热和胃肠道症状。我们报告一例因子宫穿孔继发IUD无症状移位至乙状结肠腔的特殊病例。

病例报告

在对一名53岁女性进行随访期间进行了CT扫描,该女性患有转移性舌表皮样癌,病程已达八年。扫描偶然发现乙状结肠腔内有一枚IUD。患者完全无症状且处于疾病终末期,未尝试通过手术或内镜手术取出该装置。患者四个月后因肺癌死亡;在此期间,位于结肠内的IUD一直无症状。

结论

IUD可无症状地迁移至乙状结肠腔。除了像报告的病例那样患者病情不允许的情况外,由于存在形成瘘管和结肠穿孔的风险以及随之而来的高发病率,应取出IUD。本病例报告强调了对佩戴IUD患者进行随访的必要性。

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