Gómez-Arciniega Karen D, Palomares-Castillo Erik D, Benítez-Jauregui Héctor A, Gastelum-Sarabia Jesús R, Ayala-López Marcos D
General Surgery, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, MEX.
General Surgery, Hospital General Regional No. 46, Instituto Mexicano del Seguro Social, Guadalajara, MEX.
Cureus. 2024 Aug 19;16(8):e67198. doi: 10.7759/cureus.67198. eCollection 2024 Aug.
The intrauterine device (IUD) is currently one of the most widely used methods due to its great effectiveness. Uterine perforation and migration of the device is one of its most serious complications, although rare. In most patients, it usually occurs at the time of placement and goes unnoticed; however, it can also occur late. The diagnosis is established by imaging studies, preferring abdominal ultrasound, and its treatment should be removal in all cases. We present the case of a 27-year-old woman, with a history of levonorgestrel IUD placement two years earlier, who presented with chronic pelvic pain. During a gynecological consultation, the IUD threads were not evident. An abdominal CT scan showed that the IUD was in the abdominal cavity, so open abdominal surgery was performed where the IUD was found embedded in the omentum and the segment of the omentum containing the IUD was resected. The patient evolved satisfactorily and was discharged 24 hours after surgery.
宫内节育器(IUD)因其高效性,目前是使用最广泛的避孕方法之一。尽管罕见,但子宫穿孔和节育器移位是其最严重的并发症之一。在大多数患者中,这种情况通常发生在放置节育器时且未被察觉;然而,也可能在后期发生。诊断通过影像学检查来确定,首选腹部超声,所有病例的治疗均应为取出节育器。我们报告一例27岁女性病例,她两年前放置了左炔诺孕酮宫内节育器,现出现慢性盆腔疼痛。在妇科会诊时,未发现宫内节育器尾丝。腹部CT扫描显示宫内节育器位于腹腔内,于是进行了开腹手术,术中发现宫内节育器嵌入大网膜,切除了包含宫内节育器的大网膜部分。患者术后恢复良好,术后24小时出院。