Missing intrauterine device in the descending mesocolon: Retrieval under fluoroscopy guidance in a reference hospital in southern Nigeria

Abstract

INTRODUCTION: Displaced/missing intrauterine
device (IUD) is one of the known complications
associated with the uses of IUD. Missing IUD, even
when asymptomatic, is always of concern to patients
and relatives, and could result in serious morbidity.
Retrieval of missing IUD depends on location,
facility/equipment, surgeon’s skill and experience,
and patient’s factor.

Case report: A 36 year old multipara with missing IUD
(LydiaTMCU 375 sleek) following treatment for
intrauterine adhesions. With imaging studies, the IUD
was localized at different anatomical positions with
time giving an impressing of “mobile” missing IUD. It
was subsequently retrieved in a purulent mass in the
descending mesocolon via a laparotomy aided with a
C-arm fluoroscopy imaging peri/intraoperatively.

Conclusion: Missing IUD could be lodged in unusual
anatomical locations presenting diagnostic and
treatment challenges. Imaging aids with requisite
skills and experience may be required for good
management. We believe this case is one of such,
and sharing our experience will add to the body of
knowledge