Abstract
A 77-year-old woman, who had been on hemodialysis due to chronic renal failure, was referred to our hospital for further examination of high fever and abdominal distension. There was a one-month history of poor health and she had been given antimicrobial agent at the previous hospital. When she was first seen at our hospital, tenderness over the abdomen and peritoneal irritation sign were recognized. Blood examination revealed a rise in inflammatory reaction. Abdominal contrast-enhanced CT scan showed free intra-abdominal air, ascites and an intrauterine contraceptive device (IUD). Since there was gas image inside of the uterine, around the IUD, and she had panperitonitis, uterine perforation due to the IUD was suspected. Emergency operation disclosed perforation in the uterine fundus. We performed total hysterectomy and constructed colostomy. Here, we report a rare case of panperitonitis caused by uterine perforation due to prolonged placement of IUD.
