Perforation of levonorgestrel-releasing intrauterine system found at one month after insertion:A case report  

作　　者：Guo-Rui Zhang Xin Yu 

机构地区：[1]Department of Obstetrics and Gynecology,State Key Laboratory of Complex,Severe and Rare Diseases,National Clinical Research Center for Obstetric&Gynecologic Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China

出　　处：《World Journal of Clinical Cases》2023年第1期172-176,共5页世界临床病例杂志

基　　金：Supported by National High Level Hospital Clinical Research Funding,No.2022-PUMCH-A-232。

摘　　要：BACKGROUND The levonorgestrel-releasing intrauterine system(LNG-IUS)is widely used in contraception,menorrhagia,dysmenorrhea and to prevent endometrial hyperplasia during estrogen supplementation.Perforation is more often seen after early postpartum placement.Perforation of the LNG-IUS occurring one month after placement is rare.CASE SUMMARY A 42-year-old female complained of progressive dysmenorrhea and increased menstrual volume.She was diagnosed with adenomyosis and the LNG-IUS was inserted in her uterine cavity.Routine ultrasound examination one month later revealed that the intra-uterine device(IUD)was not found in the uterine cavity,and further X-ray and pelvic magnetic resonance imaging showed an abnormal signal area in the left posterior region of the uterus.Laparoscopic exploratory surgery was performed and the LNG-IUS was found in the left uterosacral ligament.CONCLUSION Perforation of a LNG-IUS occurring one month after placement is rare,and is more common in inexperienced operators and after early postpartum placement.When the operation is difficult,ultrasound monitoring is recommended to reduce the risk of IUD perforation.For patients with inadequate surgery,postoperative imaging is recommended to detect potential risks as soon as possible.

关 键 词：Levonorgestrel-releasing intrauterine system PERFORATION MALPOSITION Case report 

分 类 号：R711[医药卫生—妇产科学]