Perforation of the appendix and the sigmoid colon by an ectopic IUD

Atolagbe O. Ayodele, Rahaman M. Oloruntobi


The perforation of both appendix and sigmoid colon by an ectopic Intrauterine device (IUD) by an intrauterine device is a rare occurrence. We present a case of a patient is a 47- year- old hispanic woman who presented at the Gynaecology clinic with complaints of chronic right sided pelvic pain. She had an intrauterine device inserted 10 years prior with no recent gynaecological follow-up. The device was identified by ultrasonography and she was planned for a hysterectomy and IUD retrieval by the gynaecology team. An intra-operative finding of sigmoid colon and appendiceal perforation by an IUD during a total abdominal hysterectomy and emergent involvement of the general surgery team. She underwent a segmental resection of the involved sigmoid colon, appendectomy and removal of the IUD.  All missing Intrauterine devices should be accurately localized by tomographic or magnetic imaging preoperatively.


Intrauterine device, Appendix, Sigmoid colon, Perforation

Full Text:



Moseley FR, Shahi N, Kurer MA. Elective surgical removal of migrated intrauterine contraceptive devices from within the peritoneal cavity: comparism between open and laparoscopic removal. JSLS 2012;16(2):236–41.

Arslan A, Kanat-Pektas M, Yesilyurt H, Bilge U. Colon penetration by a copper intrauterine device: a case report with literature review. Arch Gynecol Obstet. 2009;279:395–7.

Katara AN, Chandiramani VA, Pandya SM, Nair NS. Migration of intrauterine contraceptive device into the appendix. Indian J Surg. 2004;66:179-80.

Chen CP, Hsu TC, Wang W. Ileal penetration by a Multiload-Cu 375 intrauterine contraceptive device. A case report with review of the literature. Contraception. 1998;58(5):295-304.

Nowitzki KM, Hoimes ML, Chen B, Zheng LZ Young HK. Ultrasonography of intrauterine devices. Ultrasonography. 2015;34(3):183–94.

Weerasekera A, Wijesinghe P, Nugaduwa N. Sigmoid colo-colic fistula caused by intrauterine device migration: a case report Journal of Medical case Reports. 2014;8(1):81.

Balci O, Mahmoud AS, Capar M, Colakoglu MC. Diagnosis and management of intra-abdominal, mislocated intrauterine devices. Arch Gynecol Obstet. 2010;281(6):1019–22.

Taras AR, Kauffman JA. Laparoscopic retrieval of intrauterine device perforating the sigmoid colon. Journal of the Society of laparoscopic Endosurgeons. 2010; 14(3):453-5.

Şanlıkan F, Arslan O, Avcı M.E, Göçmen A. Laparoscopic removal of an intrauterine device from the sigmoid colon. Pak J Med Sci. 2015;31(1):214–6.

Mederos R, Humaran L, Minervini D. Surgical removal of an intrauterine device perforating the sigmoid colon: A case report. Int J Surg. 2008;6(6):60–6.

Nceboz US, Ozcakir HT, Uyar Y, Caglar H. Migration of an intrauterine contraceptive device to the sigmoid colon: a case report. Eur J contracept Reprod Health Care. 2003;8(4):229-32.

Medina TM, Hill DA, DeJesus S, Hoover F. IUD removal with colonoscopy: a case report. J reprod med. 2005;50(7):547-9.