Rahim içi araç (RİA) migrasyonuna bağlı kolon perforasyonu: akut abdomenin cerrahi yönetimi

Year 2018, Volume: 10 Issue: 1, 85 - 88, 05.04.2018

Emre Günakan , Hakan Buluş , Fatih Polat

https://doi.org/10.21601/ortadogutipdergisi.308450

Abstract

Rahim içi
araç(RİA) sık kullanılan makul ve geri dönüşümlü bir kontrasepsiyon yöntemidir.
Çalışmamızın amacı RİA’ya bağlı ciddi bir komplikasyonu literature tartışması eşliğinde
sunmaktır.

 30 yaşında 3 paritesi olan ve 3 yıldır bakırlı
RİA’sı olan kadın akut abdomen, vajinal akıntı ve 38.8℃ ateş ile
değerendirildi. Laboratuvar testlerinde C-Reaktif Protein ve beyaz küre yüksekliği
mevcuttu. Radyolojik olarak, endometrial kavite sınırları dışında RİA ve
bilateral komplike hiperintens pelvik kitleler rapor edildi. Hastaya diagnostik
laparatomi yapıldı. Pelvik apseye bağlı frozen pelvis durumu olduğu gözlendi.
Altta yatan nedenin ise rektosigmoid bileşkeye migrate olan ve perforasyona
sebep olan RİA olduğu saptandı. Hastaya subtotal histerektomi, sol
salfingoogforektomi yapılıp ve loop kolostomi açıldı. 10 günlük takibin
ardından hasta komplikasyonsuz taburcu edildi.

RİA düşük komplikasyon oranıyla kolay
uygulanabilir bir kontraseptif yöntemdir. Uzun dönemde inflamatuvar durumlara
yol açarak uterus bütünlüğünü bozabilir. Abdominal kaviteye migrasyon karın
ağrısı olan hastalarda özellikle akılda tutulması gereken ciddi bir RİA komplikasyonudur. 

Keywords

Colonic perforation, Complication, Intrauterine Device, RIA

Colonic perforation due to the migration of an intrauterine device (IUD): surgical management for acute abdomen

Abstract

Intrauterine devices (IUDs) are frequently used,reversible and feasible
contraception method. Wepresent a case involving a serious complication caused
by anIUD and discuss this case with reference to the published literature.

A 30 year-old woman with 3 parities with a copper IUD
for 3 years was evaluated for anacute abdomen, vaginal dischargeand a38.8℃
fever.Laboratory tests revealed elevation of white blood count and C-reactive
protein (CRP). Radiologically, the IUD was seen to be localised outside the
borders of the endometrial cavity, and bilateral complicated hyperintense
pelvic masses were evident. Subsequently, the patient underwent a diagnostic
laparotomy. A frozen pelvis caused by a pelvic abscess was revealed. The
underlying reason for this was the IUD that had migrated to the rectosigmoid
junction, resulting in a perforation. Subtotal hysterectomy, left
salphingooophorectomy and loop colostomy were performed.After 10 days of follow-up,
the patient was discharged without any further complication.

IUDs represent
an easily applicable contraceptive method with low complication rates. However,
over along term, an IUD may cause inflammatory disorders and disturb the
integrity of the uterus. Migration into the abdominal cavity is a serious IUD
complication that physicians should be aware of, particularly in
patients with abdominal pain.

Keywords

Colonic perforation, Complication, Intrauterine Device, RİA

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