Transfallopian expulsion of IUCD – a case report
I. Samardziski, Gl.
Dimitrov, J. Georgievska, K. Daneva, M. Pachemski
Department of Obstetrics and
Gynaecology, University of Skopje, Macedonia
Introduction: The intrauterine
contraceptive device (IUCD) is efficacious and relatively safe contraceptive,
used by the number of women in the reproductive period. Many side- effects of
IUCD have been reported. The most common are uterine perforation, unwanted
pregnancy (intrauterine or ectopic) and genital inflammatory process.
A case
report: a report about the 22-year old woman, with three children, the last
one-five months old baby that she stopped nursing a month after the birth. Three
weeks before the examination she was inserted IUCD, type NOVA. The third day
after the insertion, her second, 2-year old child, fell on her abdomen while she
slept. She felt severe short-duration pain in the lower, right part of the
abdomen. The next few days, she felt periodically sharp ‘pricking’ in the
abdomen during the physical activity and sexual intercourse. The physical
examination showed the absence of the IUCD thread and painful sensitivity in the
right adnexal region. The ultrasound study showed empty uterus and IUCD shadow
in the Douglas cavity. Explorative laparoscopy was indicated. During the
intervention, an empty uterus was registered, while one of the IUCD side arms
protruded from the abdominal aperture of the right fallopian tube. The IUCD was
removed simply by drawing out from the fallopian tube. The next day the woman
was dismissed from hospital.
Conclusion: The mechanism of the described unusual
case of transfallopian expulsion of IUCD may be the result of the severe
abdominal trauma.
