A case report of an abdominal wall fibrolipomatous capsule secondary to the migration of an intrauterine device (IUD).

INTRODUCTION

Intrauterine devices (IUDs) are the most widely used reversible contraceptive method worldwide. Uterine perforation and extrauterine migration are two complications associated with their use. We report one such case in this article.

CASE PRESENTATION: A 28-year-old female patient was admitted with a periumbilical abdominal swelling on the left side, causing minimal pain, likely parietal, that had been developing for about 1 year. Ultrasound revealed a fibrous capsule organized around an unidentified foreign body within the anterior abdominal wall. The fibrous capsule was removed via laparotomy, revealing a TCu 380 IUD inside and a scar from a uterine perforation on the uterine dome. The postoperative course was uneventful.

CLINICAL DISCUSSION: The IUD is a long-acting, non-permanent form of female contraception. Its insertion into the uterus is a simple, routine procedure, but its side effects, complications, and contraindications must be understood to optimize its effectiveness. Perforation followed by migration is a rare but serious complication. The causes are varied, ranging from uterine morphology and texture to local factors related to the IUD and the healthcare provider's inexperience. Diagnosis is often delayed, with signs related to the organ hosting the IUD confirmed by imaging. Endoscopy plays a crucial role in treatment.

CONCLUSION

Proper insertion technique and regular monitoring are essential to prevent uterine perforation and IUD migration. The IUD must be removed immediately upon diagnosis.