Abdominal Wall Abscess Presenting 35 Years After Insertion of an Intrauterine Contraceptive Device

BACKGROUND: Intrauterine devices (IUDs) are an effective means of contraception for many women worldwide. However, complications of insertion, such as uterine perforation, can lead to significant intra-abdominal problems. We present a case of an abdominal wall abscess caused by an IUD 35 years after insertion. CASE: A 52-year-old woman who had had an IUD placed approximately 35 years previously presented to our institution with fever and a left-lower-quadrant mass. A computed tomography scan demonstrated a foreign body consistent with an extrauterine IUD located within a multiloculated anterior abdominal wall fluid collection. An exploratory laparotomy confirmed that the abscess cavity involved the rectus musculature and contained the migrated IUD. CONCLUSION: This case demonstrates an unusual location for a migrated IUD. It also argues for removal of a migrated or "lost" IUD to prevent future complications. (Obstet Cynecol 2010,115:458-9)