Ogino Kensuke, Ito Hiroe, Fujimori Koji, Nakagawa Junko, Isaka Keiichi, Oishi Yasufumi
Department of Obstetrics and Gynecology, St. John's Society Sakuramachi Hospital, Tokyo, Japan.
Department of Obstetrics and Gynecology, Tokyo Medical University Hospital, Tokyo, Japan.
Gynecol Minim Invasive Ther. 2025 May 22;14(2):174-177. doi: 10.4103/gmit.GMIT-D-24-00009. eCollection 2025 Apr-Jun.
The levonorgestrel intrauterine system (LNG-IUS) is used by patients for dysmenorrhea, but cases of uterine perforation have been observed. This patient underwent replacement 5 years after the initial LNG-IUS insertion, but persistent abdominal pain led to a visit to her previous gynecologist. Transvaginal ultrasonography and magnetic resonance imaging (MRI) at the time of the visit did not detect LNG-IUS. A subsequent computed tomography (CT) scan clearly showed the entire T-shape of the LNG-IUS on the sagittal plane and revealed the presence of the LNG-IUS in the abdominal cavity. Laparoscopic observation revealed that the adhesion of the LNG-IUS was mild, and it could be removed without damaging other organs. The patient was discharged without problems on the third postoperative day. LNG-IUS extraction via ultrasonography and MRI is considered challenging due to its material characteristics. We report a case of intrabdominal LNG-IUS migration where CT and X-ray proved useful in the localization of LNG-IUS.
左炔诺孕酮宫内节育系统（LNG-IUS）被患者用于治疗痛经，但已有子宫穿孔的病例报道。该患者在初次置入LNG-IUS 5年后进行了更换，然而持续的腹痛促使她前往之前的妇科医生处就诊。就诊时经阴道超声检查和磁共振成像（MRI）均未检测到LNG-IUS。随后的计算机断层扫描（CT）在矢状面上清晰显示了LNG-IUS完整的T形，并揭示其存在于腹腔内。腹腔镜观察显示LNG-IUS的粘连较轻，可以在不损伤其他器官的情况下将其取出。患者术后第三天顺利出院。由于其材料特性，通过超声检查和MRI取出LNG-IUS具有挑战性。我们报告了一例腹腔内LNG-IUS迁移的病例，其中CT和X线检查在LNG-IUS的定位中发挥了作用。
