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01.12.2014 | Case report | Ausgabe 1/2014 Open Access

Journal of Medical Case Reports 1/2014

Sigmoid colocolic fistula caused by intrauterine device migration: a case report

Zeitschrift:
Journal of Medical Case Reports > Ausgabe 1/2014
Autoren:
Amila Weerasekera, Pravin Wijesinghe, Nilhan Nugaduwa
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1752-1947-8-81) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

AW gathered data and prepared the initial manuscript. AW performed the surgery and PW made critical revisions to the manuscript. All authors were involved in the surgical care of the patient. NN supervised the project overall. All authors read and approved the manuscript.

Abstract

Introduction

The intrauterine device is a form of contraception with a long duration of action and few systemic side effects. Migration into the abdominal cavity may occur early or years after insertion giving rise to bowel obstruction, perforation, ischemia, mesenteric injury, strictures or fistulae. Colocolic fistula formation is a rare but serious complication of intrauterine device migration, which may lead to difficulties in diagnosis and device retrieval.

Case presentation

We report the case of a 29-year-old Sri Lankan woman who became pregnant 5 years after intrauterine device insertion. The device could not be located during pregnancy. She was asymptomatic and defaulted follow up during the antenatal period. She had an uncomplicated vaginal delivery. A subsequent laparotomy for device retrieval failed due to technical difficulties. A repeat laparotomy identified a sigmoid colocolic fistula with adhesions to the fallopian tube. The device was removed and colonic defects primarily closed following which the patient made an uneventful recovery.

Conclusions

All translocated intrauterine devices should be removed regardless of type and location. This case illustrates that they may cause complex bowel lesions leading to serious technical difficulties during retrieval. With the increasing use of minimally invasive approaches for intrauterine device retrieval, a low threshold for open surgery in complicated cases is advocated.

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Zusatzmaterial
Authors’ original file for figure 1
13256_2013_2721_MOESM1_ESM.pdf
Authors’ original file for figure 2
13256_2013_2721_MOESM2_ESM.tif
Authors’ original file for figure 3
13256_2013_2721_MOESM3_ESM.pdf
Literatur
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