Wandering intrauterine contraceptive device: An unusual travel to the sigmoid colon

ABSTRACT

Intrauterine contraceptive device (IUCD) is common choice for contraception. Migration of IUCD is one of the complications that are encountered. Here we report a case of IUCD migration to the sigmoid colon. A 39-year-old Malay lady carrying a copper T type of IUCD presented with missing thread then underwent examination under anaesthesia, proceeded to hysteroscopy but failed removal. Abdominal ultrasound detected it in the left lower quadrant of abdomen. She then underwent diagnostic laparoscopy where the device was found to be embedded in the sigmoid colon. Technical difficulty necessitated conversion to mini laparotomy and sigmoidotomy to remove the IUCD and the bowel closed primarily. IUCD is a relatively simple and safe contraceptive procedure but possible complications are bleeding and pain that usually co-exist, pelvic infection, expulsion and perforation. Investigations should be based on clinical suspicion and migrated IUCD in symptomatic patients should be surgically removed whereas, asymptomatic patients can be managed conservatively under certain circumstances. However in the presence of a concurrent pathology that requires exploration then retrieval of the migrated IUCD should be undertaken.