Serdar Gökay TERZİOĞLU, Salim ERKAYA, Fatma SALİH, Özlem EVLİYAOĞLU, Huri CENGİZ, Hasan Onur TOPÇU, Esma SARIKAYA

Rektumu Perfore Eden Kayıp İntrauterin Araç: Bir Olgu Sunumu

Uzun etki süresi ve az sistemik yan etkisi olan intrauterin araç (RIA) dünyada en sık kullanılan kontraseptif yöntemlerdendir. Abdominal kaviteye migrasyonu sonucu bağırsak obstrüksiyonu, perforasyon, iskemi, mezenter yaralanması, striktür ve fistüllere neden olabilir. Rektum perforasyonu, RIA migrasyonu sonrası nadir görülen ancak ciddi bir komplikasyondur. Biz çalışmamızda kasık ağrısı şikayetiyle hastanemize başvuran ve yapılan muayene ve tetkikler sonrası rektal perforasyona neden olduğu tespit edilen 14 yıllık RIA sı olan bir vakayı sunmak istedik. Bu vakada RIA laparoskopi ve eş zamanlı kolonoskopi operasyonlarıyla çıkarıldı. RIA takılma öyküsü olan ve muayenede RIA izlenmeyen tüm hastalara ileri inceleme teknikleri uygulanarak RIAnın yeri tespit edilmeye çalışılmalıdır. Batın içine migrate olan RIAlar zamanla çeşitli komplikasyonlara yol açabileceğinden intrauterin tespit edilemeyen RIAlar öncelikle endoskopik yöntemler yardımıyla çıkarılmalıdır.

Translocated Intrauterine Device Leading to Rectal Perforation: A Case Report

Intrauterine device (IUD) is one of the most widely used contraception method in all over the world probably due to the its long duration of contraceptive and relatively less systemic side effects. Migration into the abdominal cavity may cause to bowel obstruction, perforation, ischemia, mesenteric injury, strictures or fistulae. Rectal perforation is a serious and rare complication of intrauterine device migration. We report a case of a 30-year-old woman suffering from pelvic pain who had IUD that cause to rectal perforation. She had a history of insertion of IUD before 14 years. On the first month of IUD insertion, in the controlled examination, no IUD had been detected in the uterus, therefore the clinicians had thought the IUD as dropped from vagina, no further examination had been performed. In our clinic in the detailed examination, in both ultrasonography and computered tomography confirmed the IUD in the rectovaginal space outside the uterus. All translocated intrauterine devices should be removed regardless of type and location. If it is possible minimal invasive methods as laparascopy and colonoscopy can be used.

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