Intrarectal Migration of an Intrauterine Device: A Case Study and Review of Literature

Abstract

Intrauterine devices (IUDs) are a widely used and generally safe method of long-term contraception. However, complications such as uterine perforation and migration can occur, although they are rare. This article presents a case of a 30-year-old woman with a history of two pregnancies and deliveries, who had a copper IUD inserted two years prior during the lactation period. She was admitted with severe pelvic pain and constipation lasting for three days, without externalized gastrointestinal bleeding or vomiting. Clinical examination revealed generalized abdominal tenderness with hypogastric guarding, while laboratory tests indicated elevated inflammatory markers. Imaging studies, including abdominal ultrasound and CT scan, revealed the migration of the IUD and its partial perforation into the rectal ampulla. Emergency surgery was performed, including the repair of a rectal perforation, lateral protective colostomy, and appendectomy. The postoperative course was uneventful, and colonic continuity was restored six weeks later. This case underscores the importance of considering IUD migration in a patients presenting with abdominal pain and highlights the need for timely diagnosis and intervention to prevent serious complications. Regular follow-up and patient education on the potential risks and signs of IUD complications are essential for early detection and management.