Hematochezia caused by intrauterine device perforation

We read with interest the article on the safe removal of an intrauterine device (IUD) that had perforated the rectum when a rectal approach was used [1]. In contrast, our case of perforation caused by an IUD had serious results. We report the laparoscopic findings and history of our patient to increase awareness of the potential adverse outcomes of IUDmigration. A 53-year-old postmenopausal womanwas transferred from a local clinic with hematochezia 1 month in duration. She had no history of previous surgery or medication for hypertension or hypothyroidism. An IUD had been inserted 5 years earlier. The ultrasonographic findings revealed an atrophic uterus lacking the IUD. Colonoscopic findings revealed a bleeding focus with erythematous mucosa and hemorrhagic spots 20 cm from the anus. Computed tomography (CT) scans showed that the IUDhadmigrated to the neighboring rectosigmoid junction, and the laparoscopic findings revealed severe bowel adhesion to the left cornual side of uterus (Fig. 1). We performed a laparoscopic colectomy 10.5 cm in length and 6.5 cm in diameter. The pathological findings revealed perforation with peritonitis and foreign-body reactions; see note in colectomy site and reactive hyperplasia of the lymph node. The IUD was