A 40 year old patient presented to her new gynecologist 5 years after insertion of a levonorgestrel intrauterine device (IUD) in order to have it replaced with a new one.
Her gynecologist failed to find the previous IUD and suggested that the patient might have “lost it at the toilet”. He then went on and inserted a new levonorgestrel IUD of the same type.
“The insertion of the IUD was not at all painful, not like last time”.
The patient insisted for more examinations, since she was not convinced that the old IUD simply disappeared. This led eventually to an x-ray of the abdomen which clearly showed two IUDs; one intrauterine and one intraabdominal.
The patient came to us for removal. In our work-up we asked for a preoperative low-dose abdomen CT, which verified intraperitoneal lie of the IUD and excluded bowel involvement.
Interestingly, the patient had experienced the desired amenorrhea for almost 5 years, despite the fact that the IUD was lying inside the greater omentum and not inside the uterus.
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Other interesting posts on laparoscopy:
Gynaecologia 