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Colonoscopic retrieval of migrated copper-T.

Darlong LM, Panda S, Topno N, Hajong R - J Minim Access Surg (2009)

Bottom Line: Intrauterine contraceptive devices have been in use for a long time as family planning measures, one of its complications of perforating the uterus and migrating into the peritoneal cavity is also well known.Retrieval in such cases depends on the location of the migrated intrauterine devices and involves laparotomy or laparoscopy.We present here such a case that migrated partially into the lumen of the rectosigmoid and was successfully removed using a colonoscope.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, NEIGRIHMS, Shillong, India.

ABSTRACT
Intrauterine contraceptive devices have been in use for a long time as family planning measures, one of its complications of perforating the uterus and migrating into the peritoneal cavity is also well known. Retrieval in such cases depends on the location of the migrated intrauterine devices and involves laparotomy or laparoscopy. We present here such a case that migrated partially into the lumen of the rectosigmoid and was successfully removed using a colonoscope.

No MeSH data available.


One of the T limb of Cu-T in rectum
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Figure 0003: One of the T limb of Cu-T in rectum

Mentions: Clinical examination revealed tenderness in the lower abdomen on deep palpation, no rebound tenderness, no free fluid; P/V: tenderness in the posterior fornix. P/R: mild tenderness was elicited. Pelvic X-ray showed the IUCD lying outside the uterus [Figure 1]. USG pelvis did not reveal the device. CT of the abdomen and pelvis was planned which revealed the copper T device partly in the rectosigmoid and partly in the pelvis [Figure 2]. She also had minimal free fluid in the pelvis. Hb%, total leucocyte counts and other investigations were within normal range. Necessary consent was obtained for colonoscopy and possible laparotomy. Colonoscopy was done under sedation with injection of midazolam and pethidine to assess the possibility of extraction of the device. Colonoscopy showed a part of the limb of T device as in Figure 3. It was decided that colonoscopic extraction would be attempted failing which a laprotomy was planned. Prophylactically, she was started on injection of piperacillin-tazobactum and metronidazole. Using a biopsy forceps, the “T” end of the device was pulled into the rectosigmoid. The forceps was replaced with a snare and one limb of the “T” was secured and the device extracted through the anal opening. The recto sigmoid area was inspected and no bleeding found.


Colonoscopic retrieval of migrated copper-T.

Darlong LM, Panda S, Topno N, Hajong R - J Minim Access Surg (2009)

One of the T limb of Cu-T in rectum
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2734899&req=5

Figure 0003: One of the T limb of Cu-T in rectum
Mentions: Clinical examination revealed tenderness in the lower abdomen on deep palpation, no rebound tenderness, no free fluid; P/V: tenderness in the posterior fornix. P/R: mild tenderness was elicited. Pelvic X-ray showed the IUCD lying outside the uterus [Figure 1]. USG pelvis did not reveal the device. CT of the abdomen and pelvis was planned which revealed the copper T device partly in the rectosigmoid and partly in the pelvis [Figure 2]. She also had minimal free fluid in the pelvis. Hb%, total leucocyte counts and other investigations were within normal range. Necessary consent was obtained for colonoscopy and possible laparotomy. Colonoscopy was done under sedation with injection of midazolam and pethidine to assess the possibility of extraction of the device. Colonoscopy showed a part of the limb of T device as in Figure 3. It was decided that colonoscopic extraction would be attempted failing which a laprotomy was planned. Prophylactically, she was started on injection of piperacillin-tazobactum and metronidazole. Using a biopsy forceps, the “T” end of the device was pulled into the rectosigmoid. The forceps was replaced with a snare and one limb of the “T” was secured and the device extracted through the anal opening. The recto sigmoid area was inspected and no bleeding found.

Bottom Line: Intrauterine contraceptive devices have been in use for a long time as family planning measures, one of its complications of perforating the uterus and migrating into the peritoneal cavity is also well known.Retrieval in such cases depends on the location of the migrated intrauterine devices and involves laparotomy or laparoscopy.We present here such a case that migrated partially into the lumen of the rectosigmoid and was successfully removed using a colonoscope.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, NEIGRIHMS, Shillong, India.

ABSTRACT
Intrauterine contraceptive devices have been in use for a long time as family planning measures, one of its complications of perforating the uterus and migrating into the peritoneal cavity is also well known. Retrieval in such cases depends on the location of the migrated intrauterine devices and involves laparotomy or laparoscopy. We present here such a case that migrated partially into the lumen of the rectosigmoid and was successfully removed using a colonoscope.

No MeSH data available.