Bowel Perforation by Intrauterine Device

A 41-year-old woman presented for a colonoscopy after a positive fecal occult blood test. She had no significant medical or surgical history and was asymptomatic. Colonoscopy incidentally revealed perforation of the sigmoid colon by a thin plastic object (Figure A). On detailed questioning, the patient recalled having an intrauterine device inserted 10 years ago in the United Kingdom before moving overseas. Computed tomography (Figure B and C) revealed a thin, Y-shaped foreign object in the peritoneal cavity. The patient was diagnosed with colonic perforation by an intrauterine device. The device was removed laparoscopically, and a partial sigmoidectomy was performed. The postsurgical course was uneventful. Uterine perforation is a rare complication of intrauterine device insertions that can subsequently lead to bowel perforation.