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Rare case of rectal perforation by an intrauterine device: Case report and review of the literature

INTRODUCTION AND IMPORTANCE: Intrauterine devices (IUDs) are safe, highly effective and reversible forms of contraception. Reliance on IUD has been increasing and as such, it is the responsibility of the healthcare provider to be aware of the complications associated with it. IUD rectal migration is...

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Autores principales: Boushehry, Reem, Al-Taweel, Talal, Bandar, Asya, Hasan, Maryam, Atnuos, Mario, Alkhamis, Ahmed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9568710/
https://www.ncbi.nlm.nih.gov/pubmed/36116303
http://dx.doi.org/10.1016/j.ijscr.2022.107610
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author Boushehry, Reem
Al-Taweel, Talal
Bandar, Asya
Hasan, Maryam
Atnuos, Mario
Alkhamis, Ahmed
author_facet Boushehry, Reem
Al-Taweel, Talal
Bandar, Asya
Hasan, Maryam
Atnuos, Mario
Alkhamis, Ahmed
author_sort Boushehry, Reem
collection PubMed
description INTRODUCTION AND IMPORTANCE: Intrauterine devices (IUDs) are safe, highly effective and reversible forms of contraception. Reliance on IUD has been increasing and as such, it is the responsibility of the healthcare provider to be aware of the complications associated with it. IUD rectal migration is one of the rare but serious complications that may lead to detrimental sequelae. CASE PRESENTATION: A 30-year-old asymptomatic woman presented to the gynaecology clinic two months after a difficult insertion of an IUD. On examination, the device was not localised in utero with transvaginal sonography. Computed tomography scan and colonoscopy revealed the position of the IUD within the rectum. It was successfully retrieved with a combined laparoscopic-colonoscopic approach. Follow-up flexible sigmoidoscopy showed a well-healed rectal wall. CLINICAL DISCUSSION: IUD perforation can increase the risk of morbidity and necessitates early surgical intervention even if the patient is asymptomatic. Combined laparoscopic-colonoscopic approach allows for safe retrieval of IUD that has perforated the intraperitoneal rectal segment or is firmly embedded within the mucosa. Recognising the risk factors and adhering to the principles of IUD insertion could significantly lower the risk of perforation. CONCLUSION: This case report highlights the importance of a physician's vigilance regarding a perforating IUD in a patient with a history of a difficult insertion. It is imperative to undertake additional steps to rule out such a complication in these cases. Uterine perforation can be avoided with implementation of safe IUD insertion practice.
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spelling pubmed-95687102022-10-16 Rare case of rectal perforation by an intrauterine device: Case report and review of the literature Boushehry, Reem Al-Taweel, Talal Bandar, Asya Hasan, Maryam Atnuos, Mario Alkhamis, Ahmed Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Intrauterine devices (IUDs) are safe, highly effective and reversible forms of contraception. Reliance on IUD has been increasing and as such, it is the responsibility of the healthcare provider to be aware of the complications associated with it. IUD rectal migration is one of the rare but serious complications that may lead to detrimental sequelae. CASE PRESENTATION: A 30-year-old asymptomatic woman presented to the gynaecology clinic two months after a difficult insertion of an IUD. On examination, the device was not localised in utero with transvaginal sonography. Computed tomography scan and colonoscopy revealed the position of the IUD within the rectum. It was successfully retrieved with a combined laparoscopic-colonoscopic approach. Follow-up flexible sigmoidoscopy showed a well-healed rectal wall. CLINICAL DISCUSSION: IUD perforation can increase the risk of morbidity and necessitates early surgical intervention even if the patient is asymptomatic. Combined laparoscopic-colonoscopic approach allows for safe retrieval of IUD that has perforated the intraperitoneal rectal segment or is firmly embedded within the mucosa. Recognising the risk factors and adhering to the principles of IUD insertion could significantly lower the risk of perforation. CONCLUSION: This case report highlights the importance of a physician's vigilance regarding a perforating IUD in a patient with a history of a difficult insertion. It is imperative to undertake additional steps to rule out such a complication in these cases. Uterine perforation can be avoided with implementation of safe IUD insertion practice. Elsevier 2022-09-08 /pmc/articles/PMC9568710/ /pubmed/36116303 http://dx.doi.org/10.1016/j.ijscr.2022.107610 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Boushehry, Reem
Al-Taweel, Talal
Bandar, Asya
Hasan, Maryam
Atnuos, Mario
Alkhamis, Ahmed
Rare case of rectal perforation by an intrauterine device: Case report and review of the literature
title Rare case of rectal perforation by an intrauterine device: Case report and review of the literature
title_full Rare case of rectal perforation by an intrauterine device: Case report and review of the literature
title_fullStr Rare case of rectal perforation by an intrauterine device: Case report and review of the literature
title_full_unstemmed Rare case of rectal perforation by an intrauterine device: Case report and review of the literature
title_short Rare case of rectal perforation by an intrauterine device: Case report and review of the literature
title_sort rare case of rectal perforation by an intrauterine device: case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9568710/
https://www.ncbi.nlm.nih.gov/pubmed/36116303
http://dx.doi.org/10.1016/j.ijscr.2022.107610
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