PERITONITIS DUE TO AN INTRAUTERINE CONTRACEPTIVE DEVICE

Arlinda Elmasllari

Abstract


Objectives: Reporting peritonitis as a complication to a patient holding copper IUD for 9 years, this ended in hysterectomy. Method: Reporting the case of a patient who was hospitalized and operated in gynecology at “Queen Geraldine” Hospital, Tirana. Results: Patient with high temperature of 39.5˚C, pain at the end of the abdomen with moderate intensity, with no accompanying illnesses. After ambulatory treatment with antipyretics, the complaints persisted. In this situation she was addressed to the gynecological service, “Queen Geraldine” Hospital, Tirana. In the history of the patient, she has had around 9 years since she has placed copper IUD and repeated unrecognized vaginal infections.

The ultrasound examination showed: uterus with size 86 x 53 x 56mm. The IUD was found in the cavity in a normal position, an admixed mass with a size of 66 x 55 mm of dishomogeneous content. At the Douglas level, stretching to the right adjective, a hypoecogeneous piriform mass is found in favor of a pyosalpingitis. In the hemogram obtained a leukocytosis of 22.37 x 10 * 9/L, granulocytes 20.68 x 10 * 9/L, HGB 9.4 g/dl. In the vaginal examination, the uterus was included with a massive conglomerate occupying the whole of Douglas and tamponized by intestines, dolent, with fluctuation. Affiliates included in this conglomerate. Parameters sore, infiltrated.

The patient underwent antibiotic therapy for 7 days, improving the situation of complaints and preparing for intervention. Conclusions: The patient underwent supravaginalhysterectomy and bilateralsalpingooophorectomy, a peritoneal wash, after the peritoneal generalization was found. Postoperative deafness of the patient, with early placement of peristalsis and significant improvement of the clinical staff. Antibiotic prophylaxis at the time of IUD placement, patient explanation for its complications, and correct tracking over the years are important in preventing these severe situations. It is also worth emphasizing the importance of accurate diagnosis and timely intervention in chronic SIP or generalized peritonitis. 

Recommendations: Proper timely screening and treatment of vaginal infections in IUDcarriers prevents pelvic inflammatory disease and consequently severe peritoneal complications.

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