Migration of an intrauterine device into the peritoneal cavity in a 30-year-old woman: a case report

Introduction and importance: Intrauterine devices (IUDs) are among the most effective and widely used methods of contraception worldwide, with additional non-contraceptive health benefits. Although generally safe, rare but serious complications such as uterine perforation and device migration can occur, often during or shortly after insertion. Complete migration of an IUD into the peritoneal cavity is uncommon but clinically significant, as it may lead to organ injury and delayed diagnosis due to nonspecific symptoms. This case highlights a delayed presentation of IUD migration several years after insertion and emphasizes the importance of long-term follow-up. Case presentation: A 30-year-old woman, gravida 2 para 2, presented with a 6-month history of intermittent lower abdominal and pelvic pain. She had an IUD inserted 5 years earlier with no subsequent follow-up imaging. Pelvic ultrasound and computed tomography (CT) confirmed complete migration of the IUD into the peritoneal cavity. The patient underwent diagnostic laparoscopy, during which the migrated IUD was successfully retrieved without complications. She was discharged on the same day in stable condition. Clinical discussion: IUD migration into the peritoneal cavity is a rare event, with perforation rates reported to be less than 0.5%. Risk factors include postpartum insertion, breastfeeding, uterine anatomical changes, and lack of follow-up. Symptoms may be mild or delayed, contributing to late diagnosis. Imaging modalities such as ultrasound, abdominal X-ray, and CT scan are essential for the localization of a missing IUD. Laparoscopic removal remains the preferred management strategy due to its minimally invasive nature and favorable recovery outcomes. Conclusion: Delayed migration of an IUD into the peritoneal cavity is an uncommon but potentially serious complication. Early recognition through appropriate imaging and timely surgical intervention is crucial to prevent morbidity. This case underscores the importance of patient education regarding routine follow-up and self-monitoring after IUD insertion, as well as clinicians’ awareness to ensure prompt diagnosis and management.