IUCD related silent uterine perforation

Case contributed by Ali Abougazia
Diagnosis certain

Presentation

Missed IUCD. The patient couldn't feel the threads. No abdominal or pelvic pain.

Patient Data

Age: 25 years
Gender: Female

The IUCD is seen within the anterior lower abdominal cavity, anterior to the upper sacrum, above the persumed site of the uterus.

ultrasound

The IUCD is not seen within the uterine cavity. A double walled hyperechoic structure is seen 6 cm above the uterus within the anterior lower abdominal cavity, compatible with IUCD. A small amount of pelvic fluid is also seen.

Case Discussion

This is a case of IUCD related uterine perforation, which is a rare but serious complication of an IUCD insertion, and is often silent.

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