Ineffective Pelvic Magnetic Resonance Imaging for the Detection of a Levonorgestrel-releasing Intrauterine System Straying into the Abdominal Cavity

The levonorgestrel intrauterine system (LNG-IUS) is used by patients for dysmenorrhea, but cases of uterine perforation have been observed. This patient underwent replacement 5 years after the initial LNG-IUS insertion, but persistent abdominal pain led to a visit to her previous gynecologist. Trans...

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Main Authors: Kensuke Ogino, Hiroe Ito, Koji Fujimori, Junko Nakagawa, Keiichi Isaka, Yasufumi Oishi
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Gynecology and Minimally Invasive Therapy
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Online Access:https://journals.lww.com/10.4103/gmit.GMIT-D-24-00009
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author Kensuke Ogino
Hiroe Ito
Koji Fujimori
Junko Nakagawa
Keiichi Isaka
Yasufumi Oishi
author_facet Kensuke Ogino
Hiroe Ito
Koji Fujimori
Junko Nakagawa
Keiichi Isaka
Yasufumi Oishi
author_sort Kensuke Ogino
collection DOAJ
description The levonorgestrel intrauterine system (LNG-IUS) is used by patients for dysmenorrhea, but cases of uterine perforation have been observed. This patient underwent replacement 5 years after the initial LNG-IUS insertion, but persistent abdominal pain led to a visit to her previous gynecologist. Transvaginal ultrasonography and magnetic resonance imaging (MRI) at the time of the visit did not detect LNG-IUS. A subsequent computed tomography (CT) scan clearly showed the entire T-shape of the LNG-IUS on the sagittal plane and revealed the presence of the LNG-IUS in the abdominal cavity. Laparoscopic observation revealed that the adhesion of the LNG-IUS was mild, and it could be removed without damaging other organs. The patient was discharged without problems on the third postoperative day. LNG-IUS extraction via ultrasonography and MRI is considered challenging due to its material characteristics. We report a case of intrabdominal LNG-IUS migration where CT and X-ray proved useful in the localization of LNG-IUS.
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issn 2213-3070
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publishDate 2025-04-01
publisher Wolters Kluwer Medknow Publications
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series Gynecology and Minimally Invasive Therapy
spelling doaj-art-81cc2ada56d84f498e35bb28fc2f45002025-08-20T02:02:10ZengWolters Kluwer Medknow PublicationsGynecology and Minimally Invasive Therapy2213-30702025-04-0114217417710.4103/gmit.GMIT-D-24-00009Ineffective Pelvic Magnetic Resonance Imaging for the Detection of a Levonorgestrel-releasing Intrauterine System Straying into the Abdominal CavityKensuke OginoHiroe ItoKoji FujimoriJunko NakagawaKeiichi IsakaYasufumi OishiThe levonorgestrel intrauterine system (LNG-IUS) is used by patients for dysmenorrhea, but cases of uterine perforation have been observed. This patient underwent replacement 5 years after the initial LNG-IUS insertion, but persistent abdominal pain led to a visit to her previous gynecologist. Transvaginal ultrasonography and magnetic resonance imaging (MRI) at the time of the visit did not detect LNG-IUS. A subsequent computed tomography (CT) scan clearly showed the entire T-shape of the LNG-IUS on the sagittal plane and revealed the presence of the LNG-IUS in the abdominal cavity. Laparoscopic observation revealed that the adhesion of the LNG-IUS was mild, and it could be removed without damaging other organs. The patient was discharged without problems on the third postoperative day. LNG-IUS extraction via ultrasonography and MRI is considered challenging due to its material characteristics. We report a case of intrabdominal LNG-IUS migration where CT and X-ray proved useful in the localization of LNG-IUS.https://journals.lww.com/10.4103/gmit.GMIT-D-24-00009computed tomographylaparoscopic surgerylevonorgestrel-releasing intrauterine systemmagnetic resonance imaginguterine perforation
spellingShingle Kensuke Ogino
Hiroe Ito
Koji Fujimori
Junko Nakagawa
Keiichi Isaka
Yasufumi Oishi
Ineffective Pelvic Magnetic Resonance Imaging for the Detection of a Levonorgestrel-releasing Intrauterine System Straying into the Abdominal Cavity
Gynecology and Minimally Invasive Therapy
computed tomography
laparoscopic surgery
levonorgestrel-releasing intrauterine system
magnetic resonance imaging
uterine perforation
title Ineffective Pelvic Magnetic Resonance Imaging for the Detection of a Levonorgestrel-releasing Intrauterine System Straying into the Abdominal Cavity
title_full Ineffective Pelvic Magnetic Resonance Imaging for the Detection of a Levonorgestrel-releasing Intrauterine System Straying into the Abdominal Cavity
title_fullStr Ineffective Pelvic Magnetic Resonance Imaging for the Detection of a Levonorgestrel-releasing Intrauterine System Straying into the Abdominal Cavity
title_full_unstemmed Ineffective Pelvic Magnetic Resonance Imaging for the Detection of a Levonorgestrel-releasing Intrauterine System Straying into the Abdominal Cavity
title_short Ineffective Pelvic Magnetic Resonance Imaging for the Detection of a Levonorgestrel-releasing Intrauterine System Straying into the Abdominal Cavity
title_sort ineffective pelvic magnetic resonance imaging for the detection of a levonorgestrel releasing intrauterine system straying into the abdominal cavity
topic computed tomography
laparoscopic surgery
levonorgestrel-releasing intrauterine system
magnetic resonance imaging
uterine perforation
url https://journals.lww.com/10.4103/gmit.GMIT-D-24-00009
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