Intravesical migration of intrauterine device complicated by multifocal sepsis from ruptured tubo-ovarian abscess and acute appendicitis: a comprehensive clinical case study.

BACKGROUND

Intrauterine device (IUD) migration is a rare but serious complication of IUD use, most often resulting from unnoticed uterine perforation. However, intravesical migration complicated by multifocal sepsis from ruptured tubo-ovarian abscess (TOA) and acute appendicitis is an exceedingly rare and complex clinical scenario.

CASE PRESENTATION: A 39-year-old multiparous Asian female with history of IUD placement presented with features of sepsis. Laboratory and radiological investigations, and quick sequential organ failure assessment (qSOFA) score were promptly done. The assessment was intravesical IUD migration complicated by multifocal sepsis and septic shock due to ruptured TOA and acute appendicitis. She had resuscitation and an urgent combined minimal access surgical intervention. Her postoperative recovery was rapid, and she was discharged four days after surgery.

CONCLUSION

This rare case demonstrates the importance of early recognition of sepsis, the relevant diagnostic and therapeutic challenges of managing a critically ill gynecology patient with a migrated IUD complicated by multifocal sepsis and the significance of patient education and appropriate follow-up after IUD insertion.