Appendix perforation by an intrauterine contraceptive device

Perforation of the uterus by an intrauterine contraceptive device (IUD) is a rare, and serious complication, occurring in 1/350 to 1/2500 insertions. Perforation by IUDs can involve several neighboring organs such as the blad der and rectosigmoid. We report two cases of IUD perforations involving the appendix, both inserted during lactation. The first case is an asymptomati c patient in early pregnancy and the second is a woman whose original prese ntation was chronic lower abdominal pain. The presence of copper in the abd ominal cavity can lead to adhesion formation and subsequent abdominal pain, bowel obstruction or infertility. Thus, we believe that when an IUD is loc ated in the abdominal cavity it should be removed even in an asymptomatic p atient. In addition, these cases might suggest postponing the use of this c ontraceptive method in lactating women. (C) 2000 Elsevier Science Ireland L td. All rights reserved.