PMC6304543_01
CASE 
1, pelvic ultrasound: empty uterine cavity with no evidence of intrauterine device (IUD).
CRIOG2018-9362962.001.jpg
PMC6304543_01_CRIOG2018-9362962.001.jpg
fig1
Pelvic ultrasound (Figure 1) showed an empty uterine cavity with no evidence of IUD.
CASE 
1, pelvic CT: showing anteflexed anteverted uterus with IUD outside the uterus in the cul-de-sac.
CRIOG2018-9362962.002.jpg
PMC6304543_01_CRIOG2018-9362962.002.jpg
fig2
Subsequent CT of the abdomen and pelvis (Figure 2) revealed T-shaped IUD, located midline within the posterior pelvic mesentery/cul-del-sac, superior to the posterior aspect of the anteverted uterus, and adjacent to the distal rectosigmoid colon.
CASE 
1, laparoscopic removal of Mirena IUD from posterior cul-de-sac.
CRIOG2018-9362962.003.jpg
PMC6304543_01_CRIOG2018-9362962.003.jpg
fig3
A diagnostic laparoscopy was performed (Figure 3) for retrieval and removal of malpositioned IUD and lysis of associated adhesions.
PMC6304543_02
CASE 
2, pelvic ultrasound (5/7/15): there is no sonographic evidence of IUD (intrauterine contraceptive device) identified within the uterus. The uterus measures about 11.3 x 6.4 x 7.3-cm in size, with its cervical length measuring about 4.40-cm. A single live intrauterine gestation of 6 weeks of menstrual maturity with EDD of 12/31/2015.
CRIOG2018-9362962.004.jpg
PMC6304543_02_CRIOG2018-9362962.004.jpg
fig4
The patient has a past history of ParaGard IUD placement, which was not seen in initial obstetrics sonogram at 6 weeks of gestation (Figure 4).
CASE 
2
: pelvic CT (10/15/2015) that was done postpartum day 5: a CT scan revealed a displaced IUD with its tip appearing to have penetrated the lumen of the bladder. It was located in the anterior portion of the bladder near the space of Retzius.
CRIOG2018-9362962.005.jpg
PMC6304543_02_CRIOG2018-9362962.005.jpg
fig5
CT scan revealed a displaced IUD, with the tip penetrating the lumen of the bladder, located in the anterior portion of the bladder, near the space of Retzius (Figure 5). Cystoscopy confirmed that the IUD did not penetrate mucosa.
CASE 
2, exploratory laparotomy and removal of ParaGard IUD from the seromuscular layer of the bladder.
CRIOG2018-9362962.006.jpg
PMC6304543_02_CRIOG2018-9362962.006.jpg
fig6
Patient underwent laparotomy for removal of ParaGard IUD from the serosa and muscularis layer of the bladder (Figure 6) and the layers were then repaired.
PMC6304543_03
CASE 
3, ultrasound imaging showing the embedded IUD.
CRIOG2018-9362962.007.jpg
PMC6304543_03_CRIOG2018-9362962.007.jpg
fig7
IUD in the women's clinic; IUD strings were visualized and grasped, but the device could not be removed. Initial sonogram (Figure 7) imaging showed the IUD running across the length of the cervix.
CASE 
3, CT imaging showing the embedded IUD.
CRIOG2018-9362962.008.jpg
PMC6304543_03_CRIOG2018-9362962.008.jpg
fig8
CT of abdomen and pelvis (Figure 8) showed an anteverted uterus.