Levonorgestrel intrauterine system embedded within tubal ectopic pregnancy: a case report

• Main Authors: Dorothy Makena, Ingrid Gichere, Khadija Warfa
• Format: Article
• Language: English
• Published: BMC 2021-03-01
• Series: Journal of Medical Case Reports
• Subjects: IUD; Mirena; Levonorgestrel IUS; Ectopic pregnancy; Tubal migration
• Online Access: https://doi.org/10.1186/s13256-021-02723-7

Abstract Background The presence of the levonorgestrel-releasing intrauterine system embedded within an ectopic pregnancy is a rare occurrence. Tubal migration of an intrauterine device is not well understood and has not been extensively studied in literature. Case presentation A 34-year-old African woman, para 1, gravida 2, presented with symptoms of ruptured ectopic pregnancy. She underwent a laparoscopy where a ruptured left ectopic pregnancy was found with a levonorgestrel-releasing intrauterine system inserted 2 years prior embedded within the tube. A left salpingectomy was performed with removal of the levonorgestrel-releasing intrauterine system. The patient recovered well and proceeded to have an intrauterine pregnancy 3 months later. Conclusion Migration of the levonorgestrel-releasing intrauterine system into the fallopian tube is a rare occurrence that is not well understood. In the case presented, levonorgestrel-releasing intrauterine system was found embedded within the fimbrial end of the left fallopian tube, which had a ruptured ectopic pregnancy. Surgical treatment with laparoscopy is recommended for intraabdominal intrauterine device to prevent complications.