Abstract
Rahim içi araçlar RİA , gelişmekte olan ülkelerde en sık kullanılan kontrasepsiyon yöntemidir. Ria uygulamaları sırasında görülen en ciddi komplikasyon uterus rüptürüdür ve 1-3/1000 oranında görülmektedir. 32 yaşında olan hastamızın 2 gebeliği ve 2 sezeryan operasyon öyküsü mevcuttu. Yaklaşık 1 yıl önce sezeryan doğumdan 2 ay sonra hastaya dış merkezde Cooper-T RİA uygulaması yapılmıştı. Hastanın jinekolojik muayenesinde RİA iplerinin gözlenmediği tespit edildi. Direk grafisinde RİA’nın pelvis yerleşimli olduğu tespit edildiğinden hastaya laparotomi kararı alındı. Hastaya yapılan laparotomi RİA’nın sigmoid kolon içinde kısmen seroza kısmen lümende olduğu tespit edildi. Sigmoid kolon serozası açıldı ve RİA’nın sigmoid kolondan dikkatlice çıkartılması sonrası barsak segmenti 3/0 ipek ile kapatıldı. Sonuç olarak RİA kullanımı birçok faydasına karşın uygulaması potansiyel olarak riskler içeren bir yöntemdir. RİA taktırma öyküsü olan ve muayenede RİA ipi görülmeyen hastalarda mutlaka RİA lokalizasyonu belirlenmelidir. Uterin kavitede RİA görülmeyen hastalarda uterus perforasyonu akılda tutulmalıdır
Keywords
References
- ) Caliskan E, Ozturk N, Dilbaz BO, et al. Analysis of risk factors associated with uterine perforation by intrauterine devices. Europ J Contracept Reprod Health Care ;8(3):150-5. ) Andersson K, Mattson LK, Rybo G, Stadberg E. Intrauterine release of levonorgestrel—a new way of adding progestogen in hormone replacement therapy. Obstet Gynecol 1992; 79(6): 963–7.
- ) Milsom I. The levonorgestrel-releasing intrauterine system as an alternative to hysterectomy in peri- menopausal women. Contraception 2007; 75(6 supp): –4.
- ) Mulayim B, Mulayim S, Celik NY. A lost intrauterine device. Guess where we found it and how it happened? Eur J Contracept Reprod Health Care. 2006; 11(1): 47–9.
- ) Sajjad Y, Selvan G, Kirwan JM, Kingsland CR: Gynaefix frameless IUD: Cause of bowel resection. Eur J Contracept Reprod Health Care 2006; 11(3):241-2.
- ) Mahmutyazicioglu K, Ozdemir H, Ozkan P: Migration of an intrauterine contraceptive device to the urinary bladder: sonographic findings. J Clin Ultrasound 2002; (8): 496-8.
- ) Sun CC, Chang CC, Yu MH: Far-migrated intra- abdominal intrauterine device with abdominal pain. Taiwan J Obstet Gynecol. 2008; 47(2):244-6.
- ) Disu S, Boret A. Asymptomatic ileal perforation of an intrauterine device. Arch Gynecol Obstet 2004; 269(3): 1.
Abstract
Intrauterine devices IUD is the most common contraceptive method in developing countries. The most serious complication of IUD application is uterine rupture with an incidence rate of 1-3/1000. A 32-year-old woman with 2 previous pregnancies and 2 deliveries by caesarean section presented to our institution. She had undergone Cooper-T IUD application 2 months after a cesarean section 1 year ago.On gynecological examination the IUD strings could not be visualized. A plain X-Ray showed an IUD with pelvic location. Thus, a laparotomy was performed. IUD was located in the sigmoid colon partially in serosa and lumen . The sigmoid colon serosa was opened, the IUD was removed from the sigmoid colon with care, and the affected colonic segment was closed with 3/0 silk. To conclude, despite its benefits, IUD application potentially carries some risks. IUD location should be definitely clarified in patients who have a history of IUD insertion and no IUD strings visible. Uterine perforation should be remembered in patients with no IUD visible in the uterine cavity
Keywords
References
- ) Caliskan E, Ozturk N, Dilbaz BO, et al. Analysis of risk factors associated with uterine perforation by intrauterine devices. Europ J Contracept Reprod Health Care ;8(3):150-5. ) Andersson K, Mattson LK, Rybo G, Stadberg E. Intrauterine release of levonorgestrel—a new way of adding progestogen in hormone replacement therapy. Obstet Gynecol 1992; 79(6): 963–7.
- ) Milsom I. The levonorgestrel-releasing intrauterine system as an alternative to hysterectomy in peri- menopausal women. Contraception 2007; 75(6 supp): –4.
- ) Mulayim B, Mulayim S, Celik NY. A lost intrauterine device. Guess where we found it and how it happened? Eur J Contracept Reprod Health Care. 2006; 11(1): 47–9.
- ) Sajjad Y, Selvan G, Kirwan JM, Kingsland CR: Gynaefix frameless IUD: Cause of bowel resection. Eur J Contracept Reprod Health Care 2006; 11(3):241-2.
- ) Mahmutyazicioglu K, Ozdemir H, Ozkan P: Migration of an intrauterine contraceptive device to the urinary bladder: sonographic findings. J Clin Ultrasound 2002; (8): 496-8.
- ) Sun CC, Chang CC, Yu MH: Far-migrated intra- abdominal intrauterine device with abdominal pain. Taiwan J Obstet Gynecol. 2008; 47(2):244-6.
- ) Disu S, Boret A. Asymptomatic ileal perforation of an intrauterine device. Arch Gynecol Obstet 2004; 269(3): 1.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | June 1, 2015 |
| Published in Issue | Year 2015 Volume: 19 Issue: 2 |