Laparoscopic Retrieval of a Displaced Intrauterine Device Presenting as Umbilicus Sinus

Abstract

Aim: To report a case of displaced intrauterine device (IUD), having unusual presentation, and signify the role of laparoscopy in the surgical management of migrated IUD. Background: The IUD is a popular family planning method worldwide. Intrauterine device migration into the peritoneal cavity is a serious complication and requires surgical removal in the majority of cases. In most of the reported cases, retrieval was performed through laparotomy. Moreover, cases which were attempted laparoscopically, many of them later converted to open. Also, previously published articles have mentioned migration of IUD into rectosigmoid, urinary bladder, small intestine, iliac vessels, and other sites. Ours is a probably first reported case of displaced IUD presenting as discharging umbilical sinus and surgical retrieval performed via laparoscopic approach. Case description: A 28-year-old woman presented with pain and discharge from umbilicus. Investigations revealed displaced IUD at the level of umbilicus. Patient underwent laparoscopy surgery and found to have displaced IUD, embedded in-between omental adhesion to umbilicus. Entire surgery was carried out laparoscopically and IUD removed. Patient had uneventful recovery after surgery. Conclusion: Uterine perforation following IUD insertion is a rare but potentially serious complication. Accurate preoperative localization of displaced IUD is obligatory and helpful. Current practice is to surgically remove all displaced IUDs. Laparoscopic approach appears to be safe with advantage of faster recovery and good cosmesis. Clinical significance: Our article will provide insight in erratic presentation of displaced IUD and further augment the role of laparoscopy in the management of such cases.