Laparoscopic removal of an intrauterine device following colon perforation.

BACKGROUND

Intrauterine device (IUD) migration and colon perforation is a rare but serious complication occurring sometimes years after insertion. Laparoscopic removal of a colon-perforating device is a seldom-used approach.

CASE

A 35-year-old presented with right upper quadrant (RUQ) abdominal pain one year following intrauterine device (IUD) insertion. Upon vaginal examination, no IUD string was detected. An abdominal X-ray depicted the IUD in a position below the hepatic flexure. Abdominal computerized tomography (CT) scan suggested an IUD-like foreign object posterior and medial to the hepatic flexure. Colon perforation by an intrauterine device was diagnosed, the device was identified and removed, and the intestinal damage was repaired with a laparoscopic approach.

CONCLUSION

Clinical diagnosis and surgical removal of a perforating intrauterine device reduces the possible risks of abdominal complications this condition presents. In select cases, the laparoscopic approach for intrauterine device removal may be a simple and safe approach, thus minimizing possible postoperative complications.