Perforation of the small bowel by a previously inserted intrauterine contraceptive device / 대한산부인과학회지

Intrauterine contraceptive device (IUD) is the most common contraceptive method in the world, but it exists a little risk of uterine perforation and even more severe risk such as a perforation of intra-abdominal organs. In this case, the patient recognized that the previously inserted IUD was translocated but she was asymptomatic without any management. After insertion of the second IUD, she visited our hospital for lower abdominal pain. The abdominal X-ray finding and transvaginal sonography revealed one translocated IUD in peritoneal cavity and another IUD in intrauterine cavity. Thus, we report a case with the laparoscopic diagnosis of small bowel perforation by a previously inserted IUD and its removal by segmental resection of small bowel after mini-laparotomy, along with the brief review.

A Case of Pelvic Actinomycosis Associated with Intrauterine Contraceptive Device / 대한산부인과학회잡지

Actinomycosis is a slowly progressive chronic suppurative infection noted for forming characteristic sulfur granule by an anaerobic gram-positive bateria. Pelvic actinomycosis occurs most commonly in association with IUD and has variable nonspecific symptoms that make an initial diagnosis difficult. Colonization of lower genital tract by Actinomyces occurs most often in IUD users and increases with the duration of IUD use. We experienced a case of actinomycotic pelvic abscess associated with IUD and report it with a brief review of concerned literature.

Two Cases Of The Pelvic Actinomycosis Associated With The Intestinal Obstruction / 대한산부인과학회잡지

Pelvic actinomycosis is a chronic, progressive, granulomatous and suppurative disease caused by an anaerobic or microaerobic Gram-positive organism, not fungi. Actinomyces species exhibit branching, filamentous growth and appear in the human skin, oral cavity, gastrointestinal tract. Actinomyces infection in human is relatively rare, however, prolonged use of an intrauterine contraceptive device (IUD) is a well known risk factor of pelvic actinomycosis. Pelvic actinomycosis can mimick pelvic malignancy leading to mutilating surgical excision, and diagnostic problems necessitated a laparotomy in many patients. The pathohistological diagnosis is based on the characteristic microscopic image and specific staining of sulfur granule. Adequate surgical excision and administration of antibiotics show good prognosis. We experienced 2 cases of pelvic actinomycosis with the intestinal obstruction, confirmed patho- histologically after laparotomy.

Two Cases Of The Pelvic Actinomycosis Associated With The Intestinal Obstruction / 대한산부인과학회잡지

Pelvic actinomycosis is a chronic, progressive, granulomatous and suppurative disease caused by an anaerobic or microaerobic Gram-positive organism, not fungi. Actinomyces species exhibit branching, filamentous growth and appear in the human skin, oral cavity, gastrointestinal tract. Actinomyces infection in human is relatively rare, however, prolonged use of an intrauterine contraceptive device (IUD) is a well known risk factor of pelvic actinomycosis. Pelvic actinomycosis can mimick pelvic malignancy leading to mutilating surgical excision, and diagnostic problems necessitated a laparotomy in many patients. The pathohistological diagnosis is based on the characteristic microscopic image and specific staining of sulfur granule. Adequate surgical excision and administration of antibiotics show good prognosis. We experienced 2 cases of pelvic actinomycosis with the intestinal obstruction, confirmed patho- histologically after laparotomy.

Two Cases of Pelvic Actinomycosis associated with Intrauterine Contraceptive Device (IUD) / 대한산부인과학회잡지

Actinomycosis is difficult to diagnose preoperatively because of non-specific clinical feature. We usually have excessively invasive treatment for actinomycosis. So, we must rule out actinomycosis in the case of patients with a complaint of lower abdominal pain with a long time IUD inserted state and laboratory findings suggestive of inflammation. We experienced two cases of pelvic actinomycosis associated with IUD and report these cases with a brief review of literatures.

Laparoscopic Removal of an Intrauterine Contraceptive Device That Had Migrated into the Intraabdominal Cavity

The migration of an intrauterine contraceptive device (IUD) into the intraabdominal cavity is rare. However, the removal of such as IUD is recommended for the major reason of an intraabdominal inflammatory reaction and possible bowel obstruction or perforation. We report a case of migration of an IUD into the intraabdominal cavity, which was detected twenty-four years after insertion. The IUD was successfully removed by using laparoscopic surgery on an ambulatory basis.