BACKGROUND Levonorgestrel-releasing intrauterine systems(LNG-IUSs)gradually release levonorgestrel into the uterus and is effective against hypermenorrhoea and dysmenorrhea.Complications associated with the insertion ...BACKGROUND Levonorgestrel-releasing intrauterine systems(LNG-IUSs)gradually release levonorgestrel into the uterus and is effective against hypermenorrhoea and dysmenorrhea.Complications associated with the insertion include expulsion,displacement,and uterine perforation.Ultrasonic identification of copper intrauterine devices(IUDs)is possible due to echogenicity from the copper coils.However,the barium sulfate coatings of LNG-IUSs do not always provide hyperechoic images.Both barium sulfate and copper are radiopaque and clearly identifiable on X-ray.Thus,X-ray imaging is required to locate LNG-IUSs.CASE SUMMARY A 46-year-old woman with hypermenorrhoea due to submucosal myomas was treated with LNG-IUS at another hospital.Three LNG-IUS insertions had apparently been followed by spontaneous expulsion,although objective confirmation using imaging was not performed.The patient was referred to our institution for surgery.At the first visit,there appeared to be no device in the uterus,and none was observed on transvaginal ultrasound.However,two LNGIUSs were observed in the pelvis on abdominal plain X-rays prior to surgery.Hysteroscopic myomectomy was performed,and the two LNG-IUSs were found to have perforated the myometrium.The devices were safely removed during surgery,and the submucosal myomas were also removed.The perforated section of the myometrium was minimal+ADs-therefore,a repair operation was not required.CONCLUSION Plain abdominal X-rays facilitate the determination of whether an LNG-IUS is in the uterine cavity.Therefore,it is important to confirm a device’s location,regardless of whether spontaneous expulsion is suspected,prior to inserting another device.展开更多
Hysteroscopy is widely used for the detection and treatment of intrauterine adhesion.Such technique,however,sometimes has limitations and even second damages.We report a rare case of severe intrauterine adhesion cause...Hysteroscopy is widely used for the detection and treatment of intrauterine adhesion.Such technique,however,sometimes has limitations and even second damages.We report a rare case of severe intrauterine adhesion caused by uterine perforation with a fallopian tube incarceration.A 24-year-old woman underwent severe intrauterine adhesion and secondary infertility caused by fallopian tube incaceration into the uterine cavity after postpartum curettage.First hysteroscopy created a false passage through the previous uterine perforation,entered into the cavity of incarcerated fallopian tube,and led to iatrogenic hydrosalpinx.Secondary hysteroscopy combined with laparoscopy revealed a connection between the right tubal lumen and the uterine cavity by the false passage,released the adhesion,and reconstructed the uterine cavity.Early recognition of uterine perforation or tissue incarcerarion is significant in preventing further damage.展开更多
Situs inversus is a rare congenital anomaly referring to the mirror image of the abdominal and thoracic viscera. It can be discovered routinely or on the occasion of a complication related or not to situs inversus. We...Situs inversus is a rare congenital anomaly referring to the mirror image of the abdominal and thoracic viscera. It can be discovered routinely or on the occasion of a complication related or not to situs inversus. We report a case of Situs inversus discovered incidentally during surgery for acute intestinal obstruction caused by an iatrogenic uterine perforation.展开更多
文摘BACKGROUND Levonorgestrel-releasing intrauterine systems(LNG-IUSs)gradually release levonorgestrel into the uterus and is effective against hypermenorrhoea and dysmenorrhea.Complications associated with the insertion include expulsion,displacement,and uterine perforation.Ultrasonic identification of copper intrauterine devices(IUDs)is possible due to echogenicity from the copper coils.However,the barium sulfate coatings of LNG-IUSs do not always provide hyperechoic images.Both barium sulfate and copper are radiopaque and clearly identifiable on X-ray.Thus,X-ray imaging is required to locate LNG-IUSs.CASE SUMMARY A 46-year-old woman with hypermenorrhoea due to submucosal myomas was treated with LNG-IUS at another hospital.Three LNG-IUS insertions had apparently been followed by spontaneous expulsion,although objective confirmation using imaging was not performed.The patient was referred to our institution for surgery.At the first visit,there appeared to be no device in the uterus,and none was observed on transvaginal ultrasound.However,two LNGIUSs were observed in the pelvis on abdominal plain X-rays prior to surgery.Hysteroscopic myomectomy was performed,and the two LNG-IUSs were found to have perforated the myometrium.The devices were safely removed during surgery,and the submucosal myomas were also removed.The perforated section of the myometrium was minimal+ADs-therefore,a repair operation was not required.CONCLUSION Plain abdominal X-rays facilitate the determination of whether an LNG-IUS is in the uterine cavity.Therefore,it is important to confirm a device’s location,regardless of whether spontaneous expulsion is suspected,prior to inserting another device.
文摘Hysteroscopy is widely used for the detection and treatment of intrauterine adhesion.Such technique,however,sometimes has limitations and even second damages.We report a rare case of severe intrauterine adhesion caused by uterine perforation with a fallopian tube incarceration.A 24-year-old woman underwent severe intrauterine adhesion and secondary infertility caused by fallopian tube incaceration into the uterine cavity after postpartum curettage.First hysteroscopy created a false passage through the previous uterine perforation,entered into the cavity of incarcerated fallopian tube,and led to iatrogenic hydrosalpinx.Secondary hysteroscopy combined with laparoscopy revealed a connection between the right tubal lumen and the uterine cavity by the false passage,released the adhesion,and reconstructed the uterine cavity.Early recognition of uterine perforation or tissue incarcerarion is significant in preventing further damage.
文摘Situs inversus is a rare congenital anomaly referring to the mirror image of the abdominal and thoracic viscera. It can be discovered routinely or on the occasion of a complication related or not to situs inversus. We report a case of Situs inversus discovered incidentally during surgery for acute intestinal obstruction caused by an iatrogenic uterine perforation.
