Case Report: Strangulated intestinal obstruction due to chronic migration of an intrauterine device (IUD): a 30-year latent complication

Intrauterine devices (IUDs) are widely used but carry rare risks of migration and subsequent complications, such as bowel obstruction. This case highlights the life-threatening potential of chronic IUD migration decades after insertion, emphasizing the need for heightened clinical vigilance and long...

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Main Authors: Hong-Xia Song, Tian-Hao Xie, Yan Fu, Xiao-Shi Jin, Qiang Wang, Zheng Niu, Qian Sun, Xiu-Hua An
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1613116/full
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author Hong-Xia Song
Tian-Hao Xie
Tian-Hao Xie
Yan Fu
Xiao-Shi Jin
Qiang Wang
Zheng Niu
Qian Sun
Xiu-Hua An
author_facet Hong-Xia Song
Tian-Hao Xie
Tian-Hao Xie
Yan Fu
Xiao-Shi Jin
Qiang Wang
Zheng Niu
Qian Sun
Xiu-Hua An
author_sort Hong-Xia Song
collection DOAJ
description Intrauterine devices (IUDs) are widely used but carry rare risks of migration and subsequent complications, such as bowel obstruction. This case highlights the life-threatening potential of chronic IUD migration decades after insertion, emphasizing the need for heightened clinical vigilance and long-term surveillance. A 57-year-old female patient presented to the hospital with a 2-day history of abdominal pain, accompanied by the cessation of flatus and defecation. She had one pregnancy and one vaginal delivery 31 years ago, followed by the insertion of a ring-shaped IUD 1 year postpartum. However, she had not undergone any follow-up examinations since the IUD placement. Two years prior to admission, she attempted to have the IUD removed, but it was not detected within the uterine cavity. This resulted in the assumption that the device had been spontaneously expelled, and no further investigations were pursued at that time. CT imaging revealed small bowel obstruction and a ring-shaped intra-abdominal foreign body. Emergency laparotomy identified a migrated IUD strangulating 100 cm of necrotic ileum. Upon exploration of the uterus, a fibroid was identified on the posterior wall, but no acute perforations or other pathological changes were noted. Subsequently, the IUD was removed, and bowel resection with anastomosis was performed. Chronic IUD migration may evade detection for decades, culminating in catastrophic bowel obstruction. Clinicians must maintain high suspicion for IUD-related complications in patients with abdominal pain, even years after insertion. Prophylactic removal of misplaced devices and long-term imaging surveillance are critical to prevent morbidity. Early recognition of such rare but severe complications through comprehensive clinical assessment and imaging studies can significantly improve patient outcomes and reduce the risk of life - threatening bowel - related events.
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spelling doaj-art-a6fbb70ec8a24c54aa29adc7edb622642025-08-20T03:33:07ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.16131161613116Case Report: Strangulated intestinal obstruction due to chronic migration of an intrauterine device (IUD): a 30-year latent complicationHong-Xia Song0Tian-Hao Xie1Tian-Hao Xie2Yan Fu3Xiao-Shi Jin4Qiang Wang5Zheng Niu6Qian Sun7Xiu-Hua An8Department of General Surgery, Affiliated Hospital of Hebei University, Baoding, Hebei, ChinaDepartment of General Surgery, Affiliated Hospital of Hebei University, Baoding, Hebei, ChinaBasic Research Key Laboratory of General Surgery for Digital Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei, ChinaDepartment of Ophthalmology, Baoding No. 1 Central Hospital, Baoding, Hebei, ChinaDepartment of General Surgery, Affiliated Hospital of Hebei University, Baoding, Hebei, ChinaDepartment of General Surgery, Affiliated Hospital of Hebei University, Baoding, Hebei, ChinaDepartment of General Surgery, Affiliated Hospital of Hebei University, Baoding, Hebei, ChinaDepartment of General Surgery, Affiliated Hospital of Hebei University, Baoding, Hebei, ChinaDepartment of Internal Medicine, Wangdu County Chinese Medicine Hospital, Baoding, Hebei, ChinaIntrauterine devices (IUDs) are widely used but carry rare risks of migration and subsequent complications, such as bowel obstruction. This case highlights the life-threatening potential of chronic IUD migration decades after insertion, emphasizing the need for heightened clinical vigilance and long-term surveillance. A 57-year-old female patient presented to the hospital with a 2-day history of abdominal pain, accompanied by the cessation of flatus and defecation. She had one pregnancy and one vaginal delivery 31 years ago, followed by the insertion of a ring-shaped IUD 1 year postpartum. However, she had not undergone any follow-up examinations since the IUD placement. Two years prior to admission, she attempted to have the IUD removed, but it was not detected within the uterine cavity. This resulted in the assumption that the device had been spontaneously expelled, and no further investigations were pursued at that time. CT imaging revealed small bowel obstruction and a ring-shaped intra-abdominal foreign body. Emergency laparotomy identified a migrated IUD strangulating 100 cm of necrotic ileum. Upon exploration of the uterus, a fibroid was identified on the posterior wall, but no acute perforations or other pathological changes were noted. Subsequently, the IUD was removed, and bowel resection with anastomosis was performed. Chronic IUD migration may evade detection for decades, culminating in catastrophic bowel obstruction. Clinicians must maintain high suspicion for IUD-related complications in patients with abdominal pain, even years after insertion. Prophylactic removal of misplaced devices and long-term imaging surveillance are critical to prevent morbidity. Early recognition of such rare but severe complications through comprehensive clinical assessment and imaging studies can significantly improve patient outcomes and reduce the risk of life - threatening bowel - related events.https://www.frontiersin.org/articles/10.3389/fmed.2025.1613116/fullintrauterine device (IUD)strangulated intestinal obstructionmigrationuterine perforationcase report
spellingShingle Hong-Xia Song
Tian-Hao Xie
Tian-Hao Xie
Yan Fu
Xiao-Shi Jin
Qiang Wang
Zheng Niu
Qian Sun
Xiu-Hua An
Case Report: Strangulated intestinal obstruction due to chronic migration of an intrauterine device (IUD): a 30-year latent complication
Frontiers in Medicine
intrauterine device (IUD)
strangulated intestinal obstruction
migration
uterine perforation
case report
title Case Report: Strangulated intestinal obstruction due to chronic migration of an intrauterine device (IUD): a 30-year latent complication
title_full Case Report: Strangulated intestinal obstruction due to chronic migration of an intrauterine device (IUD): a 30-year latent complication
title_fullStr Case Report: Strangulated intestinal obstruction due to chronic migration of an intrauterine device (IUD): a 30-year latent complication
title_full_unstemmed Case Report: Strangulated intestinal obstruction due to chronic migration of an intrauterine device (IUD): a 30-year latent complication
title_short Case Report: Strangulated intestinal obstruction due to chronic migration of an intrauterine device (IUD): a 30-year latent complication
title_sort case report strangulated intestinal obstruction due to chronic migration of an intrauterine device iud a 30 year latent complication
topic intrauterine device (IUD)
strangulated intestinal obstruction
migration
uterine perforation
case report
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1613116/full
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