THE SILENT ASSASSIN: A RARE CASE OF INTRAUTERINE DEVICE MIGRATION AND SIGMOID COLON PERFORATION WITH PUBLIC HEALTH IMPLICATIONS

Background: Intrauterine devices (IUDs) are widely used for long-term contraception and are considered safe and effective. However, rare complications such as uterine perforation and extrauterine migration can result in serious outcomes. This report describes a rare instance of IUD migration into the sigmoid colon and discusses broader public health implications. Case Presentation: A 32-year-old woman presented with lower abdominal pain, diarrhea, and fever. One year earlier, an IUD was inserted during the postpartum period. At a 5-month follow-up for pain and bleeding, the IUD threads were missing. Spontaneous expulsion was assumed, and no imaging was performed. At presentation, imaging revealed a migrated IUD embedded in the sigmoid colon with perforation and abscess formation. Laparoscopic retrieval and bowel repair were performed. The patient recovered uneventfully. This case underscores the Conclusion: need for structured follow-up after IUD insertion and highlights the importance of imaging when thread loss is observed. Timely diagnosis and minimally invasive management can prevent complications. Public health systems must incorporate safety protocols into contraceptive programs to avoid such outcomes.