Presentation
Post-menopausal with abdominal pains, acute in nature. Left hypochondriac tenderness. History of contraceptive device placement 37 years ago.
Patient Data
A tubular, hyperechoic thick linear structure which on its axial plane demonstrates rosette-beaded semblance with each of its transverse sections exhibiting sonolucent centers (labeled 'b') and uniformly rounded outer rings (labeled 'a'), is noted within the fundal endometrial cavity distributing intense distal intermittent acoustic shadow artifacts. A solitary incidental small sized subserosal uterine fibroid is chanced as well at the fundal-anterior uterine wall.
Case Discussion
Lippes loop contraceptive device morphologically sonographically is quite different from the copper-T IUCD, Multiload, Mirena and the rest, which currently are in circulation. Whereas Lippes loop intrauterine contraceptive device's usage and circulation ceased at around early1980s following its first introduction in 1965 1,2, some patients may still present with the thick coily, polyethylene plastic-made contraceptive device.
In this presentation, the patient affirmatively agreed on the contraceptive device had still been in situ over the years and was locating its current position for possible removal. Relevant clinical history and unmistakable sonographic imaging in this case, excluded any remote possibility of focal osseous endometrial hyperplasia which easily could have masqueraded within the endometrial cavity as a possible differential.
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