Importance of abdominal X-ray to confirm the position of levonorgestrel-releasing intrauterine system:A case report  

作　　者：Aki Maebayashi Kanoko Kato Nobuki Hayashi Masaji Nagaishi Kei Kawana 

机构地区：[1]Obstetrics and Gynecology,Nihon University Hospital,Tokyo 1018309,Japan [2]Obstetrics and Gynecology,Nihon University School of Medicine,Tokyo 1738610,Japan

出　　处：《World Journal of Clinical Cases》2022年第15期4904-4910,共7页世界临床病例杂志

摘　　要：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.

关 键 词：Hysteroscope Intrauterine devices Levonorgestrel-releasing intrauterine system Submucosal myoma Uterine perforation Case report 

分 类 号：R169.41[医药卫生—公共卫生与预防医学]