Acute Peritonitis Complicating Sigmoid Colon Perforation by Migrating Intrauterine Device: A Case Report and Review of The Literature

Abstract

Introduction: Intrauterine device (IUD) migration is a rare situation which can cause some serious complication such as colon perforation and high risk of infection. Its treated surgically by laparoscopy or laparotomy depending of the difficulties and complications. Presentation of Case: We show the case of a 45 year old woman, G2 P2 carrying an IUD for 15 years, who consulted for abdominal pain and fever. Abdominal imaging revealed the presence of intraperitoneal effusion of medium abundance and pneumoperitoneum. Diagnostic laparoscopy was done and the IUD was found to be embedded in the wall of the sigmoid colon which was removed after laparotomy conversion by excision of the involved segment followed by the suturing and drainage. Conclusion: In rare cases IUD can migrate, still asymptomatic for years or cause sometimes serious complications like intestinal perforation or abscess and peritonitis, this risk must be avoided by treating all migrating IUD even asymptomatic ones.