INTRAABDOMINAL MIGRATING of the INTRAUTERINE CONTRACEPTIVE DEVICE (IUD)

HUNG THIEN NGUYEN,  TRUNG CHI HO,  CONG VAN NGUYEN,  HAI THANH PHAN

MEDIC MEDICAL CENTER, HCMC, VIETNAM

 ABSTRACT:

 OBJECTIVE:

To compare ultrasound, X-rays and CT in detection of  the IUD migrating  because sometimes ultrasound could not reveal any IUD in whom said having an IUD.

 MATERIAL and METHODS:

A descriptive, cross-sectional prospective study from 2005 to 2010 in Medic Medical Center, HCM City. When X-rays detects a mispositioned IUD, the patient will be reexamined by ultrasound and then by CT.

 RESULTS:

05 cases of uncomplicated migrating and 01 case of complicated migrating. All of uncomplicated cases happened in over 50 year-old patients without clinical signs. Most of cases with Dana IUD type, and one case had removed the uterus (case 5). One case has a perforation of the rectum by one of two T shape type IUDs which exist together in a patient suffering bloody stools and abdominal pain for 2 years. An other case has 2 kinds of IUD together (case 4): one Dana and other T shape IUD type.

DISCUSSIONS:

One case on the left side of  abdominal cavity. 4/6 cases on the right side. Ultrasound  itself cannot disclose migrating IUD. Ultrasound failed to detect an intraabdominal IUD (case 3). Intra-abdominal migrating IUDs were uncertain masses of 21-45mm with mixed and hyperechoic pattern without acoustic shadowing.

CONCLUSIONS:

Migration of IUD may happen in women having IUD. X-rays has effective role to detect the intra and extrauterine IUD. Ultrasound discloses difficultly intraabdominal migrating cases. CT scan reveals exactly the migrating IUD inside / outside of hollow viscera (uterine tube, bladder, colon, appendix).

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