[The migrating intrauterine device. Case report and review of the literature].

We report a case of migration of an intrauterine contraceptive device (IUCD) detected during pregnancy one year after insertion. The advanced gestation of the pregnancy and the absence of symptoms lead to expectant management. There were no complications during the pregnancy or delivery. A CT Scan in the post-partum period suggested that the IUCD was located in the region of the small bowel. Laparoscopy confirmed that the IUCD was superficially embedded in the intestinal wall but with no mucosal lesion. The device was removed with the aid of a mini-laparotomy. The migration of an IUCD into the abdominal cavity is rare. A literature review spanning the past 18 years revealed 165 reported cases. The IUCD was located in the following sites: omentum 45, rectosigmoid 44, peritoneum 41, bladder 23, appendix eight, small bowel two, adnexa one, iliac vein one. The majority of the authors recommend removal of copper containing devices, because of the potential for inflammatory reactions that can cause bowel obstruction and perforation. Initial laparoscopy has mostly superceded laparotomy but conversion may be necessary if difficulties arise.