Asymptomatic Intrauterine Device Migration with Rectal Perforation and Tubo-Ovarian Abscess: A Rare Case Presentation

Intrauterine devices (IUDs) are widely used contraceptives. Migration or uterine perforation should always be suspected in cases of gynecologic infections. These rare complications can lead to serious problems in adjacent organs (1,2). We report a case of a 32-year-old woman, gravida 2 para 2, who presented for routine IUD follow-up with mild right iliac fossa discomfort. She had a copper IUD inserted two years earlier, with regular follow-up and no prior symptoms. Pelvic ultrasound revealed IUD migration associated with a right tubo-ovarian abscess, and a subsequent CT scan identified rectal perforation. The patient underwent successful laparoscopic management by a multidisciplinary team, including rectal and uterine repair and abscess drainage. The postoperative course was uneventful. This case highlights the importance of considering IUD migration in patients presenting with abdominal pain, even after long asymptomatic periods (3,4).