国际生殖健康/计划生育杂志 ›› 2026, Vol. 45 ›› Issue (4): 294-296.doi: 10.12280/gjszjk.20260170

• 病例报告 • 上一篇    下一篇

宫内节育器直肠异位并经肛门脱出一例

司中华(), 丁洋, 徐翎翎   

  1. 210003 南京中医药大学附属南京中医院肛肠外科
  • 收稿日期:2026-03-31 出版日期:2026-07-15 发布日期:2026-07-27
  • 通讯作者: 司中华 E-mail:sizhonghua@sina.com
  • 基金资助:
    江苏省中医临床优秀人才研修项目(苏中医科教[2025]9号)

Intrauterine Contraceptive Device with Rectal Ectopia and Transanal Protrusion: A Case Report

SI Zhong-hua(), DING Yang, XU Ling-ling   

  1. Colorectal Surgery, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210003, China
  • Received:2026-03-31 Published:2026-07-15 Online:2026-07-27
  • Contact: SI Zhong-hua E-mail:sizhonghua@sina.com

摘要:

宫内节育器(intrauterine contraceptive device,IUD)异位是IUD放置后少见但严重的并发症,IUD异位后可导致子宫穿孔、出现腹腔内异物,甚至侵蚀邻近脏器。报告1例IUD穿透子宫后进一步侵蚀直肠并最终经肛门脱出的罕见病例。患者因肛门异物脱出5 d就诊,经腹腔镜探查联合经肛门异物取出术成功取出IUD,术后恢复良好,无并发症。结合文献复习,探讨IUD直肠异位的发生机制、诊断策略及微创手术治疗方案。对于有IUD放置史、出现肛门异物或直肠刺激症状的患者,应警惕IUD异位可能;腹腔镜探查联合经肛门异物取出术是安全有效的治疗选择。

关键词: 宫内避孕器, 宫内避孕器游走, 肠穿孔, 腹腔镜检查, 病例报告

Abstract:

Ectopic of the intrauterine contraceptive device (IUD) is a rare but serious complication following IUD insertion. Ectopic of the IUD can lead to uterine perforation, formation of an intra-abdominal foreign body, and even erosion into adjacent organs. We report a rare case in which an IUD penetrated the uterus, eroded through the rectum, and was eventually protruded via the anus. The patient presented with anal protrusion for 5 days, and successfully underwent the laparoscopic exploration combined with transanal removal of the foreign body. The postoperative course was uneventful with no complications. By reviewing relevant literature, we discuss the pathogenesis, diagnostic strategies, and minimally invasive surgical management of rectal ectopia of the IUD. Clinicians should maintain a high index of suspicion for IUD ectopia in patients with a history of IUD placement who present with anal protrusion or symptoms of rectal irritation. Laparoscopic exploration combined with transanal removal of the foreign body represents a safe and effective therapeutic option for this condition.

Key words: Intrauterine devices, Intrauterine device migration, Intestinal perforation, Laparoscopy, Case reports