Abstract

1. Abstract
1.1.
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.
1.2.
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.
1.3.
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.
2. Introduction
Intrauterine devices (IUD) are effective, safe, and widely used. It is actually the most used contraception mean in Tunisia 22% Their use is about 14.7% in the developing countries and 8.9% in developed ones [1]. The perforation of the uterus by the IUD is a relatively rare complication whose incidence is estimated between 1.3 and 1.6 per 1000 insertions [2], but the consequences can be very serious. It can occur immediately or several years after the insertion of the device [3]. Ectopic migration of IUD with involvement of adjacent organs can cause catastrophic complications such as gastrointestinal perforation [4]. Ideal treatment of IUD migration remains controversial [5]. We report a case of an ectopic migration of IUD with sigmoid colon perforation.