Wangwe Peter Joseph, Awadh Najma, Angelus Magreth
Department of Obstetrics and Gynecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Obstetrics and Gynecology, Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania.
Contracept Reprod Med. 2024 Jul 25;9(1):36. doi: 10.1186/s40834-024-00278-8.
Loss of Intra Uterine Device (IUD) following silent perforation of the uterus either during or after IUD insertion is an uncommon finding due to a lack of immediate follow-up. We report a rare case in which uterine perforation following the migration of IUD to the right fallopian tube without visceral injury. The patient presented with lower abdominal pain and pain during sex for one year since IUD insertion. On examination, we noted tenderness on the right suprapubic region and on speculum examination, no IUD thread was seen. A radiological pelvic examination showed an empty uterus without an IUD. Laparotomy and retrieval of migrated IUD was done followed by repair of perforated uterus.
Migrated IUD with silent uterine perforation without visceral injury is a distressing clinical condition both to the patient and the clinician. This case is reported to increase awareness in doing immediate vaginal examination and pelvic ultrasound post-IUD insertion.
宫内节育器(IUD)在插入过程中或插入后因子宫隐性穿孔而丢失,由于缺乏即时随访,这种情况并不常见。我们报告一例罕见病例,宫内节育器迁移至右侧输卵管后发生子宫穿孔,但无内脏损伤。该患者自放置宫内节育器后出现下腹部疼痛和性交痛一年。检查时,我们发现耻骨上区右侧有压痛,阴道窥器检查未见宫内节育器尾丝。盆腔放射学检查显示子宫内无宫内节育器。进行了剖腹手术并取出迁移的宫内节育器,随后修复穿孔的子宫。
宫内节育器迁移伴子宫隐性穿孔且无内脏损伤,对患者和临床医生来说都是令人困扰的临床情况。报告此病例是为了提高对放置宫内节育器后立即进行阴道检查和盆腔超声检查的认识。