Thursday, August 16, 2012

Intraperitoneal Migration of an Intrauterine Device

As intrauterine devices have become a common form of contraception worldwide, their normal and abnormal imaging appearance should be recognized. The stem of a properly positioned intrauterine device (IUD) should be entirely within the endometrial cavity with the arms extending laterally at the uterine fundus. The device should never be seen in the endocervical canal.

An IUD may be expulsed from the uterine cavity or displaced within it. Perforation through the uterus and migration into the peritoneal cavity is a rare complication. An intraperitoneal IUD may cause bowel/omental adhesions, abscess formation, or perforation of intraabdominal structures. Timely surgical intervention can prevent these complications.

Boortz HE, Margolis DJA, Ragavendra N, et al. Migration of intrauterine devices: radiologic findings and implications for patient care. Radiographics. 2012 March;32:335-52.
Peri N, Graham D, Levine D. Imaging of intrauterine contraceptive devices. J Ultrasound Med 2007;26(10):1389-1401.
Images courtesy of Anna Nazarenko, M.D.

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