Mystery at the Navel-A Surgical Detective Story on Migration of Copper T to the Anterior Abdominal Wall: A Case Report and Review of the Literature

Background: Uterine perforation and extra-uterine migration of intrauterine devices (IUDs) are uncommon complications. Migration to the anterior abdominal wall is extremely rare, with only sporadic reports in the literature.
Case presentation: We report a 22 year-old woman who presented with one month history of pain and discharge from the umblicus. She had a history of Copper T insertion three years earlier. Clinical examination revealed a firm, non-tender swelling in the lower anterior abdominal wall. Ultrasonography and computed tomography demonstrated a T-shaped metallic foreign body located in the anterior abdominal wall, superficial to the rectus sheath. The device was successfully retrieved through a diagnostic laparoscopy followed by open omphalectomy. The postoperative period was uneventful.
Conclusion: Migration of a Copper T to the anterior abdominal wall is an exceptionally rare occurrence. Missing IUD threads should prompt evaluation for migration. A combination of ultrasound, X-ray, and CT scan aids accurate localization. Surgical retrieval, either laparoscopic or open, remains the definitive management.

Copper T, intrauterine device, uterine perforation, migration, anterior abdominal wall, laparoscopy

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