2018 Volume 43 Issue 6 Pages 1065-1070
An 82-year-old woman with lower abdominal pain was referred to our hospital. Her symptoms and CT suggested strangulated ileus. An emergency laparoscopy-assisted operation was performed. The laparoscopy showed bloody ascites in the cavitas pelvis and strangulated ileum obstruction caused by an intrauterine device (IUD). We resected the annular part of the IUD at outside of the abdomen. Although the strangulation was relieved, the color of the strangulated ileum did not improve. Therefore, we resected the necrotic bowel. The patient had an uneventful postoperative recovery and was discharged on the eighth postoperative day. We suppose the IUD uterine perforation in this patient was caused by uterine atrophy and uterine contraction. A strangulated ileus into an IUD is rare. Older female patients who use IUDs have a risk of acute abdominal pain. Therefore, it is important to interview patients regarding the IUD insertion or removal history.
