Aliukonis Vygintas, Lasinskas Marius, Pilvelis Algirdas, Gradauskas Audrius
Department of Abdominal Surgery, Clinic of Surgery, Vilnius City Clinical Hospital, Antakalnio 57, LT-10207, Vilnius, Lithuania; Centre for Health Ethics, Law and History, Institute of Health Sciences, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania.
Department of Abdominal Surgery, Clinic of Surgery, Vilnius City Clinical Hospital, Antakalnio 57, LT-10207, Vilnius, Lithuania.
Int J Surg Case Rep. 2020;72:306-308. doi: 10.1016/j.ijscr.2020.06.011. Epub 2020 Jun 12.
Colon perforation caused by the intrauterine device (IUD) migration is rare, but severe complication that can occur years after the insertion. Depending on the location of the injured intestine, the different methods for extracting migrated IUD raging from colonoscopy to laparotomy can be chosen.
A 41-year-old female presented with the discomfort in the epigastric area went to the outpatient clinic. A doctor performed gastroscopy and found a polyp. During a colonoscopy, we found a small solid object protruding through the intestinal wall. CT scan showed IUD like "T" shape foreign body, which longest part was protruding a wall of the colon. After these CT findings, the patient informed us that she had IUD inserted almost ten years ago. We found the device with the laparoscopic approach. IUD was removed and the intestinal damage was repaired during the mini-laparotomy.
Perforation of IUD can be asymptomatic, although sometimes it can cause short-term or long-term symptoms. Penetrated IUDs should be removed whenever identified. For intra-abdominal penetrations, the laparoscopic or mini-laparotomy approach is a safe and appropriate method.
宫内节育器(IUD)移位导致的结肠穿孔很少见,但却是一种可能在放置多年后出现的严重并发症。根据受损肠道的位置,可以选择从结肠镜检查到剖腹手术等不同的方法来取出移位的IUD。
一名41岁女性因上腹部不适前往门诊。医生进行了胃镜检查并发现了一个息肉。在结肠镜检查期间,我们发现一个小的固体物体从肠壁突出。CT扫描显示为“T”形异物的IUD,其最长部分突出于结肠壁。根据这些CT检查结果,患者告知我们她大约在十年前放置了IUD。我们通过腹腔镜手术找到了该装置。在小型剖腹手术中取出了IUD并修复了肠道损伤。
IUD穿孔可能无症状,尽管有时会引起短期或长期症状。一旦发现穿透性IUD,应予以取出。对于腹腔内穿透,腹腔镜或小型剖腹手术方法是一种安全且合适的方法。