Intrauterine device migration resulting in acute appendicitis: A case report

• Published in: International journal of surgery case reports Vol. 117; p. 109515
• Main Authors: Sebai, A., Elaifia, R., Atri, S., Hammami, M., Haddad, A., Kacem, J.M.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-04-2024; Elsevier
• Subjects: Appendicitis; Case Report; Intrauterine device; Migration; Perforation; Case report; Perforation; Appendicitis; Migration; Intrauterine device
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.109515

The Intrauterine Contraceptive Device (IUD), a widely used contraceptive since 1965, has demonstrated efficacy but is associated with complications such as bleeding, pain, and rare occurrences of perforation. This case report details an IUD migration into the peritoneal cavity, leading to acute appendicitis.
A 33-year-old woman, with a history of IUD insertion 16 months prior, presented with pelvic pain. Gynecological examination and computed tomography, revealed the IUD intraperitoneal migration. The patient underwent laparoscopic extraction of the IUD which was embedded in the appendix and appendectomy, with an uneventful recovery.
This case emphasizes the complexity of IUD migration and its rare association with acute appendicitis, underscoring the importance of vigilant monitoring and prompt intervention.
We also explored factors contributing to IUD perforation risk, imaging modalities for detection, and emphasizes the necessity of surgical removal upon confirmation. We highlight the fact that despite the atypical presentation with minimal symptoms, we should always consider emergency situations. Surgical intervention, particularly laparoscopy, may be the standard approach for managing migrated IUDs.
We insist about the critical need for thorough assessment and vigilance in managing IUD-related complications, emphasizing timely intervention to ensure patient safety. This case contributes valuable insights into the complexities surrounding IUD migration, urging healthcare professionals to remain attentive to potential injuries in patients with a history of IUD insertion and abdominal pain.
•The Intrauterine Contraceptive Device (IUD) is a widely used contraceptive method, but its popularity is accompanied by potential complications.•Uterine perforation is a rare but serious complication of IUD insertion leading to severe complications that may require intensive treatments, including surgery.•We highlight a novel occurrence of IUD migration into the peritoneal cavity, causing acute appendicitis. We performed a laparoscopic extraction.•This case also highlights the importance risk factor consideration and IUD continuous follow-up to avoid complications, such as acute appendicitis to ensure patient safety.