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Safe Laparoscopic Surgical Approach of Foreign Body Migration

Alvarenga S Emanuela, MD, Aupont Schlermine, MD, Derek McCranie, Alexander Ramirez, MD, FACS. Florida State University

Intrauterine device (IUD) migration out of the uterine cavity is a serious complication. Its incidence in the US has been reported to be about 0.001% annually. Previously published systematic review supports the use of laparoscopic surgery for elective removal of migrated IUCDs from the peritoneal cavity. We present the safety and efficacy of the Laparoscopic approach to this complication in the acute care setting.  Depicted is an otherwise healthy 40 year old female with no previous surgical history who presented to the ED with worsening abdominal pain for one week with no associated symptoms. On physical exam, patient was non toxic. Abdomen was moderately distended with  guarding and rebound tenderness to palpation, no rigid. Patient had been seen shorlty prior to ED admission by her OBGYN and recent work up with abdominal/pelvic x-ray and ultrasound  has revealed a misplaced IUD in the transverse position (side ways). Pregnancy test was negative.  Based on patient clinical presentation and recent radiologic findings, we decided to proceed with Diagnostic Laparoscopy. After systematic  review of cavity, the foreign body was found to be incorporated within the greater omentum. We procceded, laparoscopically with omentectomy + foreign body removal. There were no perioperative complications, patiet was discharged on the following day.

The use of laparoscopy in elective IUD retrieval within in the abdominal cavity has been considered standard of care in surgical management to date.   This poster demonstrates its use as an effective approach for safe removal of intra-abdominal foreign bodies also in the acute setting.

 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87454

Program Number: P072

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

77

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