Presentation
Right-sided flank pain. In view of history of renal calculi, an unenhanced CT scan was performed.
Patient Data
Unenhanced abdominal CT shows an intrauterine device, which has migrated from the lumen of the uterus through the uterine wall and part of the device is now intra-abdominally located. No signs of fat infiltration, free fluid or air in the abdomen. So, no signs of further complications.
Case Discussion
Uterine perforation is a serious complication. It occurs in roughly 1/1000 cases. There are not many risk factors documented, but lactating and having had a baby within 6 months prior to placement are risk factors. The degree of malpositioning of an intrauterine device can range from embedment in the myometrium to complete perforation1.
Malpositioning of the IUD can be assessed by ultrasound, but CT can be used to exclude other causes, to evaluate the precise location and to assess possible complications that have occurred.
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