Contraception 91 (2015) 431
Letter to the Editor Reply to Letter to the Editor entitled: "Hematochezia caused by intrauterine device perforation"☆,☆☆
To the Editor:
We thank Dr. Kim and colleagues for their response to our case report and for sharing their experience with an intrauterine device (IUD) perforation of the bowel that led to serious injury and major morbidity. While our patient was fortunate not to have significant sequelae from rectal perforation, we certainly recognize that this is not always the case, as demonstrated by your patient who required partial colectomy. From reading your letter, we agree that your workup of this symptomatic patient was appropriate and ultimately led to the correct diagnosis and treatment. Our patient was asymptomatic; she presented for a routine annual exam, and IUD strings were not seen at the time of pelvic exam.
☆
Financial support: The authors have no funding sources to report. Disclosures: The authors have no potential conflicts of interests to disclose. ☆☆
0010-7824/© 2015 Elsevier Inc. All rights reserved.
Although computed tomography (CT) imaging was obtained and assisted our management of this patient, we do not advocate for routine CT scan in all women with IUDs outside the uterus, particularly in an asymptomatic patient. When routine care including physical exam, ultrasound, X-ray and laparoscopy do not lead to localization and removal of the IUD after uterine perforation, CT can be a helpful next step in localization of the IUD. Lisa Goldthwaite* Kristina Tocce Division of Family Planning, Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Aurora, CO ⁎Corresponding author at: University of Colorado Anschutz Medical Campus, Department of Obstetrics and Gynecology, 12631 E. 17th Avenue, Box B-198-2, Aurora, CO 80045. E-mail address: [email protected] http://dx.doi.org/10.1016/j.contraception.2015.01.020
Letter to the Editor Reply to Letter to the Editor entitled: "Hematochezia caused by intrauterine device perforation"☆,☆☆
To the Editor:
We thank Dr. Kim and colleagues for their response to our case report and for sharing their experience with an intrauterine device (IUD) perforation of the bowel that led to serious injury and major morbidity. While our patient was fortunate not to have significant sequelae from rectal perforation, we certainly recognize that this is not always the case, as demonstrated by your patient who required partial colectomy. From reading your letter, we agree that your workup of this symptomatic patient was appropriate and ultimately led to the correct diagnosis and treatment. Our patient was asymptomatic; she presented for a routine annual exam, and IUD strings were not seen at the time of pelvic exam.
☆
Financial support: The authors have no funding sources to report. Disclosures: The authors have no potential conflicts of interests to disclose. ☆☆
0010-7824/© 2015 Elsevier Inc. All rights reserved.
Although computed tomography (CT) imaging was obtained and assisted our management of this patient, we do not advocate for routine CT scan in all women with IUDs outside the uterus, particularly in an asymptomatic patient. When routine care including physical exam, ultrasound, X-ray and laparoscopy do not lead to localization and removal of the IUD after uterine perforation, CT can be a helpful next step in localization of the IUD. Lisa Goldthwaite* Kristina Tocce Division of Family Planning, Department of Obstetrics and Gynecology, University of Colorado Denver School of Medicine, Aurora, CO ⁎Corresponding author at: University of Colorado Anschutz Medical Campus, Department of Obstetrics and Gynecology, 12631 E. 17th Avenue, Box B-198-2, Aurora, CO 80045. E-mail address: [email protected] http://dx.doi.org/10.1016/j.contraception.2015.01.020
