Lost and Found: A Case of Missing Intrauterine Contraceptive Device

Abstract

The common presentation of patients coming with a misplaced or migrated intrauterine copper device (IUCD) is either absence of strings, or they may become pregnant, while in majority, they may remain asymptomatic. In a developing country like India, contraception is treated like a national emergency. The IUCD is a commonly used contraceptive methods around the world, but it is associated with complications, which are rare. Uterine perforation is the most dreadful complication of the IUCD, which needs surgical intervention. A high degree of clinical suspicion is needed to identify it and Imaging is the best modality to diagnose the same. The IUCD can migrate or get misplaced within the peritoneal cavity, either partially or completely.
We present a case of a 36-year-old female with obstetric score of Para 3 with persistent, mild & dull aching pain in the lower abdomen. She had history of postpartum IUCD insertion five years ago followed by an abortion a year later. With the utilization of imaging modalities, the IUCD was seen on X-ray & Ultrasonography (USG). To remove the migrated IUCD an exploratory laparotomy using a small incision was done.