Oliver Joshua J, Kelly Ethan P, Aller Forest C, Bridwell Rachel E, Stremick Justine K
Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, USA.
Cureus. 2024 Jun 25;16(6):e63097. doi: 10.7759/cureus.63097. eCollection 2024 Jun.
Long-acting intrauterine contraceptives such as intrauterine devices (IUD) are popular due to their high rates of long-term efficacy, ease of use, and reversibility. Though rare, these devices can incur complications such as uterine perforation. Signs and symptoms are often vague abdominal and pelvic pain, and patients rarely present with a surgical emergency. This uterine perforation can happen immediately upon IUD placement or in a delayed manner. This case details an example of an IUD uterine perforation with abdominal migration two years after placement. The patient's history is complicated by the unique fact that she became pregnant and carried her pregnancy to a term vaginal delivery after the IUD had been placed. Her pregnancy led healthcare providers from previous encounters to believe that the IUD had been spontaneously expelled. The IUD was identified in the patient's left lower abdominal cavity via computed tomography (CT) and was surgically removed uneventfully.
长效宫内节育器,如宫内节育器(IUD),因其长期高效、使用方便和可逆性而广受欢迎。尽管这些装置引发子宫穿孔等并发症的情况罕见,但症状通常是腹部和盆腔隐痛,患者很少出现外科急症。这种子宫穿孔可能在放置宫内节育器后立即发生,也可能延迟出现。本病例详细介绍了一例放置宫内节育器两年后子宫穿孔并伴有腹腔内移位的情况。该患者的病史较为复杂,因为在放置宫内节育器后她怀孕并足月顺产。她的怀孕让之前接诊的医护人员认为宫内节育器已自行排出。通过计算机断层扫描(CT)在患者左下腹腔发现了宫内节育器,并顺利通过手术取出。