Radiologie casus: Buikpijn

Plaatjes kijken doen we niet zo erg veel in onze Bachelorjaren, maar het is altijd goed om hiermee te oefenen. Lees onderstaande casus door en kijk eens kritisch naar de plaatjes bijbehorend bij deze casus. Wat zie je daar nou precies? Waarom presenteert deze patiënt zich met pijn?


Case

A 35-year-old female patient presents with mild abdominal pain present for several weeks. Physical
examination is unremarkable, besides some pain in the left upper quadrant during palpation. An
abdominal ultrasonographic examination was normal. An abdominal radiograph was made (fig. 1).
What’s going on?
figure-1

figure-2

figure-3

Answer:

In the left upper quadrant an Intra Uterine Device (IUD) is visible (fig. 2). Of course the uterus is not
located there. For comparison a radiograph of an IUD in a normal position is shown (fig 3).
Perforation of an IUD is rare complication (0,4/1000 in a recent study 1) ). The IUD was removed by
laparoscopy and afterwards the patient was free of complaints.

1) Kaislasuo J et al. Uterine perforation caused by intrauterine devices: clinical course and treatment.
Human Reproduction 2013;28:1546-51