Transmigration of copper T presenting as abdominal wall mass: a case report

T. Ramani Devi, S. Shameema Banu, T. Harini, P. Kanimozhi


Copper T is one of the widely used intra uterine contraceptive devices due to its safe, effective and reversible nature. It has also been widely used as it is cost effective too. Copper T is usually inserted immediate post-partum, post abortal, during the proliferative phase of any menstrual cycle or 6 to 8 weeks following post-partum. Complications associated with use of Copper T include heavy menstrual bleeding, pelvic inflammatory disease, uterine perforation, displacement and rarely, transmigration. Post-insertion of copper T, women need to have regular follow up visits to prevent such complications. Patients should be advised to check for the presence of threads periodically. Considerable number of patients with transmigration of copper T has been reported in literature. Sites into which transmigration has been reported include broad ligament, ovarian fossa, urinary bladder, sigmoid colon, rectum, peritoneum, omentum, pouch of douglas, retro peritoneal space, iliac veins, ovaries, appendix and rarely in the abdominal wall. Transmigrated copper T may be diagnosed with ultrasonogram, X-ray and CT scan. Copper containing intra-uterine devices are known to provoke inflammatory reactions and symptoms depending upon the sites to which they have been transmigrated. Hence, we should resort to early intervention and remove the misplaced copper IUCD at the earliest. Here, we are reporting a rare case of transmigration of copper T into the anterior abdominal wall elaborating on various facets of copper T including its advent, incidence of use, efficient diagnosis and well-planned retrieval. 


Anterior abdominal wall, Displacement of copper T, Transmigration of IUCD, Retrieval of copper T

Full Text:



Elahi N, Koukab H. Diagnosis and management of lost intrauterine contraceptive device. J Pak Med Assoc. 2002;52(1):18-20.

Bednarek PH, Creinin MD, Reeves MF, Cwiak C, Espey E, Jensen JT. Immediate versus delayed IUD insertion after uterine aspiration. N Engl J Med. 2011;364(23):2208-17.

Rivera R, Yacobson I, Grimes D. The mechanism of action of hormonal contraceptives and intrauterine contraceptive devices. Am J Obstet Gynecol. 1999; 181(5):1263-9.

Sharma M, Joshi S, Nagar O, Sharma A. Determinants of intrauterine contraceptive device discontinuation among Indian women. J Obstet Gynecol India. 2014;64(3):208-11.

Ohana E, Sheiner E, Leron E, Mazor M. Appendix perforation by an intrauterine contraceptive device. Eur J Obstet Gynecol Reprod Biol. 2000;88(2):129-31.

Sasidharan K, Chally R. Intravesical migration of Lippes loop with stone formation. Brit J Urol. 1988;61(4):363.

Laxmi M, Hemlata J, Rani LP. An unusual case of copper-T in the rectum. J Obstet Gynecol India. 2005;55(1):79-80.

Browning JJ, Bigrigg MA: Recovery of the intrauterine contraceptive device from the sigmoid colon. Three case reports. Br J Obstet Gynaecol 1988;95:530-2.

Mansoor T, Aslam M, Rizwi S, Haseen M. Copper-T causing perforation of sigmoid colon. Surg. 2006;13(1).

Kassab B, Audra P. The migrating intrauterine device. Case report and review of the literature. Gynecol Obstet Fertil. 1999;27(10):696-700.

Sarkar P. Translocation of a copper 7 intra-uterine contraceptive device with subsequent penetration of the caecum: case report and review. BMJ Sexual Reprod Health. 2000;26(3):161-8.

Silva PD, Larson KM. Laparoscopic removal of a perforated intrauterine device from the perirectal fat. JSLS. 2000;4(2):159.

Roy KK, Banerjee N, Sinha A. Laparoscopic removal of translocated retroperitoneal IUD. Int J Gynecol Obstet. 2000;71(3):241-3.

Demirci D, Ekmekçioğlu O, Demirtaş A, Gülmez İ. Big bladder stones around an intravesical migrated intrauterine device. Int Urol Nephrol. 2003;35(4): 495-6.

Ansari MM, Harris SH, Haleem S, Fareed R, Khan MF. Foreign body granuloma in the anterior abdominal wall mimicking an acute appendicular lump and induced by a translocated copper-T intrauterine contraceptive device: a case report. J Med Case Reports. 2009;3(1):1-3.

Chang HM, Chen TW, Hsieh CB, Chen CJ, Yu JC, Liu YC, Shen KL, Chan DC. Intrauterine contraceptive device appendicitis: a case report. World J Gastroenterol. 2005;11(34):5414.

Hasanain FH. The misplaced IUD. Int J Gynaecol Obstet. 2002;78(3):251-2.

Yilmaz Y, Bayrakli H, Cecen K, Güneş M. An unusual foreign body in the bladder. Eastern J Med. 2002;7(2):43-4.

Aghaways I, Wahid SA, Ali RH, Sabir F, Kakamad FH. Migration of an intrauterine device to the left inguinal region, the first reported case. Int J Surg Case Rep. 2016;28:68-70.

Chell KI, Lipscomb GH. Abdominal wall abscess presenting 35 years after insertion of an intrauterine contraceptive device. Obstet Gynecol. 2010;115(2): 458-9.

Singhal SR, Marwah DS, Paul A, Singhal SK. Missed intra uterine device: a rare indication for appendicectomy-case report with review of literature. East Cent Afr J Surg. 2010;15(2):156-8.

Arif SH, Mohammed AA. Migrated intrauterine device presented as anterior abdominal wall abscess. J Surg Case Rep. 2019;2019(6):rjz174.

Li-li H. X.-l. S., Shao-hua LLW. The clinical role of ultrasound in inserting intrauterine device and diagnosing IUD abnormal position. China Med Herald 2008;5:55.

Koo HR, Oh YT, Kim YT, Kim SW, Kang JH, Kim KW. Intrauterine device found in an ovarian carcinoma. J Comput Assist Tomogr. 2008;32(1):69-71.

Moulay A, Zahi M. Abdominal migration of intrauterine-devices-a report of 4 cases removed by laparoscopy. Semaine des hopitaux. 1983;59(42): 2905-9.

Eke N, Okpani AO. Extrauterine translocated contraceptive device: a presentation of five cases and revisit of the enigmatic issues of iatrogenic perforation and migration. Afr J Reprod Health. 2003;52:117-23.

Mittal S, Gupta I, Lata P, Mahajan U, Gupta AN. Management of translocated and incarcerated intrauterine contraceptive devices. ANZ J Obstet Gynaecol. 1986;26(3):232-4.

Assaf A, El Tagy A, El Kady A, El Agezy H. Hysteroscopic removal of copper-containing intrauterine devices with missing tails during pregnancy. Adv contraception. 1988;4(2):131-5.

El-Hefnawy AS, El-Nahas AR, Osman Y, Bazeed MA. Urinary complications of migrated intrauterine contraceptive device. Int Urogynecol J. 2008;19(2):241-5.

Ozgun MT, Batukan C, Serin IS, Ozcelik B, Basbug M, Dolanbay M. Surgical management of intra-abdominal mislocated intrauterine devices. Contraception. 2007;75(2):96-100.

Otolorin EO. Management of the lost IUD. Afr J Med Med Sci. 1985;14(3-4):125-9.