Résumé

Introduction: Uterine perforation with intrauterine device (IUD) migration is a rare but serious complication of intrauterine contraception. We report two cases of IUD migration managed at the Regional University Hospital Center (CHRU) of Fada N'Gourma, Burkina Faso. Clinical cases: These were two patients aged 26 and 37 years, respectively, multiparous, who had undergone IUD insertion on day 42 postpartum. The diagnosis of migration was suspected due to the disappearance of the reference threads and confirmed by abdominopelvic computed tomography (CT), which located the IUD in intraperitoneal and visceral positions. A laparotomy was indicated. It allowed, in the first case, the discovery of an IUD adherent to the sigmoid colon with colonic perforation requiring excision-suturing of the colon, and in the second case, an IUD located in the pouch of Douglas without associated visceral injury. The postoperative courses were uncomplicated in both cases. Conclusion: IUD migration is a rare complication, the diagnosis of which relies primarily on pelvic ultrasound to ensure uterine emptiness, and secondly on a plain abdominal X-ray (without preparation) which can reveal the IUD, without indicating its abdominal or pelvic topography, hence the need for CT and/or MRI. In case of confirmed ectopic position, surgical removal is imperative. Laparoscopy remains the reference approach; laparotomy remains an alternative in resource-limited settings.

Mot-clés :

Intrauterine Device, Uterine Perforation, Migration