Santos Ariel P, Wetzel Cate, Siddiqui Zia, Harper David Shane
Department of Surgery, Texas Tech University Health Science, Lubbock, Texas, USA.
Texas Tech University Health Sciences Center, Amarillo, Texas, USA.
BMJ Case Rep. 2017 Sep 27;2017:bcr-2017-221342. doi: 10.1136/bcr-2017-221342.
Intrauterine device (IUD) is a popular long-acting reversible contraceptive device with an estimated rate of use of about 5.3%. It is highly effective but not without complications, one of which is uterine perforation. The patient was a 32-year-old female who presented with nausea, vomiting and right upper quadrant abdominal pain that was tender on palpation. CT scan was performed and they found signs of acute calculous cholecystitis with incidental finding of a migrated IUD in the left lateral mid-abdomen within the peritoneal cavity. She underwent a laparoscopic cholecystectomy followed by a successful IUD retrieval. Most uterine perforations occur at the time of insertion; however, partial perforation with subsequent delayed complete perforation may also occur. This case emphasises the importance of a full workup for a missing IUD and that, if incidentally found, IUDs can be removed safely laparoscopically in conjunction with another procedure.
宫内节育器(IUD)是一种广受欢迎的长效可逆避孕装置,估计使用率约为5.3%。它非常有效,但并非没有并发症,其中之一就是子宫穿孔。患者为一名32岁女性,出现恶心、呕吐和右上腹腹痛,触诊时有压痛。进行了CT扫描,发现有急性结石性胆囊炎的迹象,偶然发现一枚移位至腹腔左侧中腹部的宫内节育器。她接受了腹腔镜胆囊切除术,随后成功取出了宫内节育器。大多数子宫穿孔发生在放置时;然而,也可能发生部分穿孔并随后延迟出现完全穿孔的情况。该病例强调了对失踪宫内节育器进行全面检查的重要性,并且,如果偶然发现,宫内节育器可以在腹腔镜下与另一手术同时安全取出。