Retrieval of lost Copper-T from the rectum
Banerjee, N.; Kriplani, A.; Roy, K.K.; Bal, S.; Takkar, D.
European Journal of Obstetrics Gynecology and Reproductive Biology 79(2): 211-212
1998
ISSN/ISBN: 0301-2115 PMID: 9720843 DOI: 10.1016/s0301-2115(97)00249-2Document Number: 276513
Presented is the case of a translocated Copper-T IUD, lying partly in the lumen of the rectum, which was removed through the rectal route. The 36-year-old patient presented to a hospital in New Delhi, India, with amenorrhea of 3 months' duration. A test for pregnancy was positive. A Copper-T IUD had been inserted, without difficulty, 6 years earlier, but had never been checked or replaced. The IUD threads could not be visualized. At elective abortion, the IUD was not found in the uterus or with the products of conception. Laparoscopy revealed an old healed perforation on the fundus of the uterus and adhesions of bowel loops in the pouch of Douglas. On laparotomy, thickening of the anterior rectal wall was detected, but no obvious perforation site was evident. Finally, rectal examination was performed and the vertical limb of the IUD was palpated 9 cm above the anus; the horizontal arm remained buried in the rectal wall. The device was removed intact with forceps. The literature includes only eight other cases of perforation of the rectosigmoid by an IUD and its retrieval through the rectal route. This case study underscores the need for rectal examination in cases of lost IUDs.