Peritoneal Carcinomatosis with Displaced IUCD

Abstract

Intrauterine contraceptive device (IUCD) has been widely used as a safe, economic, effective and reversible method of contraception. IUCDs are generally well accepted with good compliance but complications sometime occur. Uterine perforation is a rare complication with an incidence of one in 1000 procedures. Whether a displaced IUCD in the peritoneum can lead to carcinogenesis is a matter of debate. We report a case of peritoneal carcinomatosis with displaced Lippes loop. A 70 year female with ascites who was diagnosed as peritoneal carcinomatosis and administered two cycle of chemotherapy presented to this institution for further management. She was evaluated, administered four more cycles of chemotherapy and taken for exploratory laparotomy. At laparotomy a Lippes loop was found adherent to the colon and omentum. Total abdominal hysterectomy, bilateral salpingo-oopherectomy, total omentectomy and transverse colon resection with end to end anastomosis was done. Post operative histopathology showed adenocarcinoma in colon and omentum located around the loop. Uterus, ovaries and rest of the bowel were free of disease. She received two more cycles of chemotherapy after operation. She has completed follow up of 6 weeks after completion of treatment with clinically no evidence of disease.