Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB.
Department of Obstetrics, Gynaecology, and Reproductive Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB.
J Obstet Gynaecol Can. 2021 Jun;43(6):760-762. doi: 10.1016/j.jogc.2020.09.015. Epub 2020 Sep 30.
Colorectal injury from an intrauterine device (IUD) is rare but may lead to major complications.
A 55-year-old woman presented to a tertiary care hospital with 4 days of generalized weakness, confusion, dysuria, and lower back pain. She provided a vague history of an unsuccessful attempt to remove an IUD 30 years prior. A computed tomography scan demonstrated an IUD in the rectal lumen, with gluteal and pelvic gas and fluid collections. Emergency surgery found necrotizing fasciitis. Despite multiple debridements, sigmoidoscopic IUD removal, and long-term intravenous antibiotics, the patient died from sepsis and multiorgan failure.
IUDs require proper monitoring and timely removal to prevent potential complications associated with organ perforation.
宫内节育器（IUD）导致的结直肠损伤罕见，但可能导致严重并发症。
一名 55 岁女性因全身乏力、意识模糊、尿痛和腰痛 4 天就诊于一家三级保健医院。她含糊地回忆起 30 年前曾试图取出 IUD 但未成功。计算机断层扫描显示 IUD 在直肠腔内，伴有臀部和骨盆积气和积液。急诊手术发现坏死性筋膜炎。尽管多次清创、乙状结肠镜下取出 IUD 和长期静脉内使用抗生素，患者仍死于脓毒症和多器官衰竭。
IUD 需要适当监测和及时取出，以预防与器官穿孔相关的潜在并发症。
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