{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T17:35:11Z","timestamp":1770831311653,"version":"3.50.1"},"reference-count":20,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,1,28]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>Uterine perforation is a potentially serious uncommon complication of intrauterine device (IUD) use. It has an incidence of one in 1000 insertions. It can manifest with abnormal uterine bleeding and pain. The most common site of implantation is the omentum. Risk factors include breastfeeding, &lt;6 months postpartum, lack of experience of the healthcare professional, congenital uterine anomalies and nulliparity. Transvaginal ultrasound scan (USS) is accurate in localisation of the Mirena IUD. If the IUD is not evident within the uterus, an abdominal radiograph should be performed. Laparoscopic surgery is the preferred method for successfully removing a malpositioned device. The authors present the case of a multiparous woman in her early 20s presenting with abdominal pain and \u2018lost\u2019 Mirena IUD threads. A pelvic USS showed no evidence of an IUD inside the uterus. An abdominal radiograph confirmed the IUD in the pelvis. The IUD was removed laparoscopically and her abdominal pain resolved. This case provides a cautionary reminder that a migrated IUD may cause abdominal pain.<\/jats:p>","DOI":"10.1136\/bcr-2025-271044","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T16:46:31Z","timestamp":1770828391000},"page":"e271044","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic retrieval of a levonorgestrel intrauterine device in a patient presenting with abdominal pain"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5499-415X","authenticated-orcid":false,"given":"Louise","family":"Dunphy","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Boyle","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy","family":"Weetch","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"2026021108462596000_19.2.e271044.1","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1055\/s-0029-1201695","article-title":"Ein Mittel zur Verhutung der Konzeption [A means of preventing conception]","volume":"35","author":"Richter","year":"1909","journal-title":"Dtsch Med Wochenschr"},{"key":"2026021108462596000_19.2.e271044.2","unstructured":"Grafenberg E . Die intrauterine methode der konzeptionverhutung. In: Haire N , ed. Proceedings of the Third World League for Sexual Reform Congress; London, UK: Kegan Paul, Trench, Turner and Company, 166\u201375. London."},{"key":"2026021108462596000_19.2.e271044.3","doi-asserted-by":"publisher","DOI":"10.3109\/13625180903519885"},{"key":"2026021108462596000_19.2.e271044.4","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det074"},{"key":"2026021108462596000_19.2.e271044.5","unstructured":"Drug analysis print for levonorgestrel. Medicines and Healthcare Regulatory Agency (MHRA); 2015. Available: http:\/\/www.mhra.gov.uk\/home\/groups\/publc\/documents\/sentineldocuments\/dap4168594933298485pdf"},{"key":"2026021108462596000_19.2.e271044.6","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1016\/S0140-6736(00)90820-1","article-title":"MIGRATION OF A GR\u00c4FENBERG RING","volume":"222","author":"Murphy","year":"1933","journal-title":"The Lancet"},{"key":"2026021108462596000_19.2.e271044.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1936.92770300002009a"},{"key":"2026021108462596000_19.2.e271044.8","unstructured":"WHO Scientific Group . Mechanism of action, safety and efficacy of intrauterine devices. technical report series 753. Geneva, Switzerland World Health Organization; 1987."},{"key":"2026021108462596000_19.2.e271044.9","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1016\/0002-9378(73)90128-2","article-title":"A Dalkon Shield imbedded in a myoma: Case report of an unusual displacement of an intrauterine contraceptive device","volume":"117","author":"Esposito","year":"1973","journal-title":"Am J Obstet Gynecol"},{"key":"2026021108462596000_19.2.e271044.10","doi-asserted-by":"crossref","unstructured":"Van Schoubroeck D , Van Den Bosch T , Ameye L , et al . Eur J Obstetrics Gynaecol Reprod Biol 2013;154\u20136. doi:10.1016\/j.ejogrb.2013.08.029","DOI":"10.1016\/j.ejogrb.2013.08.029"},{"key":"2026021108462596000_19.2.e271044.11","unstructured":"Singhal SR , Marwah DS , Paul A , et al . Missed intrauterine device: a rare indication for appendectomy \u2013 case report with review of literature. East Cent Afr J Surg 2010;15."},{"key":"2026021108462596000_19.2.e271044.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2015.01.007"},{"key":"2026021108462596000_19.2.e271044.13","doi-asserted-by":"crossref","first-page":"41","DOI":"10.2147\/OAJC.S458156","article-title":"Migration of Intra-Uterine Devices","volume":"15","author":"Verstraeten","year":"2024","journal-title":"Open Access J Contracept"},{"key":"2026021108462596000_19.2.e271044.14","doi-asserted-by":"crossref","first-page":"4544","DOI":"10.1016\/j.radcr.2024.07.073","article-title":"Severe complications of intrauterine device migration: Case reports of rectal perforation and omental localization","volume":"19","author":"Benchaou","year":"2024","journal-title":"Radiol Case Rep"},{"key":"2026021108462596000_19.2.e271044.15","unstructured":"FRSH guideline: intrauterine contraception. 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