Laparoscopic Removal of Intra-Abdominal Intrauterine Device: A Case Report and Literature Review

Introduction: Uterine perforation with an intra-abdominal intrauterine device (IUD) resulting in consultation to a general surgeon is rare. However, migrated IUD due to uterine perforation, regardless of the severity of symptoms, should be promptly removed surgically to avoid further bowel perforation or obstruction. We report a case of intra-abdominal IUD utilizing laparoscopic removal. Case: A 28-year-old woman who suffered from vaginal spotting for six months following levonorgestrel IUD (Mirena®, Bayer, Leverkusen, Germany) implantation. An initial diagnostic workup, including the performance of a transvaginal ultrasound, pelvis X-ray, and pelvic computed tomography (CT) scan, was completed to localize the IUD. Then, laparoscopy was performed to remove the device smoothly. Conclusions: Intra-abdominally-located IUDs due to uterine perforation are usually diagnosed by gynecologists, but further consultation to general surgeons can be encountered sometimes. Imaging studies such as pelvic X-ray or abdominal CT are recommended to assess adjacent organ involvement or perforation. Laparoscopic extraction are feasible and beneficial in most cases.