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Case report
Endoscopic removal of an incidentally discovered intrauterine contraceptive device eroding into the rectum
  1. Mahdi Abdulrasoul Al Sahaf1,
  2. Bahaa Farouk Bseiso1,
  3. Sami Abdulmohsin Al-Momen1 and
  4. Abdul-Wahed Nasir Meshikhes2
  1. 1 Department of Gastroenterology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
  2. 2 Department of Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia
  1. Correspondence to Dr Abdul-Wahed Nasir Meshikhes, meshikhes{at}


Intrauterine contraceptive device (IUCD) is a common birth control method. It is safe but can be associated with serious complications including migration into the peritoneal cavity and penetration into other intra-abdominal and pelvic viscera; most commonly the rectosigmoid colon. Different retrieval methods including endoscopy, laparoscopy or open abdominal surgery have been described. We report the case of 38-year-old woman who became pregnant shortly after insertion of the IUCD 6 years prior to presentation. She delivered vaginally and ‘expulsion’ of the device was assumed. Some 4 years later, she had another IUCD inserted and remained asymptomatic till she recently presented with iron-deficiency anaemia. As part of the investigation, diagnostic colonoscopy was performed. Surprisingly, the old IUCD was found penetrating into the midrectum. Uneventful endoscopic removal was performed and she remained well at 3-month follow-up. Migrating IUCD remains asymptomatic and may be discovered accidentally during routine investigation for some other symptoms.

  • endoscopy
  • contraception

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  • Contributors MAAS collected the clinical data and searched the literature. BFB searched the literature and wrote the initial draft. SAA-M was the primary physician, managed the case and participated in writing the final draft. A-WNM participated in the management of patient and wrote the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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