Go back
Title: AN INCIDENTAL DIAGNOSIS OF TRANSMIGRATION OF COPPER T : A CASE REPORT.
e-poster Number: EP 258
Category: Sexual and Reproductive Health and Rights and Contraception
Author Name: Dr. Shubhra Agarwal
Institute: TMMC&RC
Co-Author Name:
Abstract :
Introduction-
Intrauterine contraceptive device (IUCD) is the main stay of contraception especially in developing countries, despite side effects and complications like menstrual bleeding, pelvic pain, infection and uterine perforation. Uterine perforation is a rare but serious complication. The reported incidence of perforation varies considerably from 1 in 350 to 1 in 2500.
Case
A 36 year female P3L3(all vaginal deliveries) came with complaint of dull aching lower abdominal pain with severe dysmenorrhea since menarche gradually increasing in intensity. On per vaginal examination uterus was anteverted 14weeks in size. Her Ultrasound was done S/o encysted collection on anterior wall of body of uterus .On laparoscopy an isolated mass approx. 5x5 cm was visualised near left cornua and suspicion of ACUM was made due to its location. Dense adhesions were present on anterior abdominal wall and while adhesiolysis a resistance could be felt which was grasped and intraop X- Ray was taken that suggested Copper T along the anterior abdominal wall near umbilicus. Laparoscopically it was not possible to remove the Cu-T due to the position of Cu-T near umbilicus. Therefore, laparotomy was done and simultaneously ACUM was excised and copper T removed. HPE report further confirmed the diagnosis of ACUM.
Discussion-
The most common site for migration of copper T after perforation is omentum, followed by rectosigmoid, peritoneum, bladder, ovary. The mechanism of migration is thought to be the insertion procedure itself or a chronic inflammatory reaction with a gradual erosion through the uterine wall. Our patient was a case of ACUM with incidental diagnosis of transmigration of Copper T.
Conclusion- Although IUCD is a safe, cheap, easily reversible, effective and convenient method of contraception proper timing, insertion technique , regular follow-up and self-checking of Cu-T strings for presence is a must.
