A 47-Year-Old Woman with Gastric Transmigration of an Intrauterine Contraceptive Device Managed by Laparoscopic Wedge Gastric Resection

Abstract

Patient: Female, 47-year-old Final Diagnosis: Perforated intrauterine contraceptive device Symptoms: Asymptomatic Medication:— Clinical Procedure: — Specialty: Surgery Objective: Unusual clinical course Background: Intrauterine contraceptive devices (IUCD) are commonly used. Although IUCD use is considered safe, one adverse event is uterine perforation and its migration into surrounding organs. Migrations into the urinary bladder and the intestine have been sometimes reported. We here report a very rare case in which an IUCD migrated into the stomach; gastric endoscopy incidentally revealed the IUCD half embedded and half in the gastric lumen. To our knowledge, this is the second report ever of IUCD migration into the stomach. Case Report: A 47-year-old woman with BMI 36.2 visited us as a candidate for an intragastric balloon to reduce her weight. An IUCD was inserted 18 years ago and was not yet removed. Diagnostic gastric endoscopy revealed a foreign body appearing to be an IUCD. Endoscopic removal failed. Computed tomography indicated the presence of an IUCD through the gastric cavity and thus we performed laparoscopic removal of the IUCD with wedge resection of the stomach. A penetrating IUCD was confirmed. Conclusions: A gastric foreign body can be a migrated IUCD. Although rare, we must be aware that IUCDs can migrate into unexpected organs.