Re: Looking for listers' recommendations
From: R. Daniel Braun (rd.braun@gmail.com)
Wed Feb 25 13:56:29 2009
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It is my understanding that the copper can cause a lot of adhesions. For
this reason, ot should probably be removed. However, since it has been there
so long this might not be a very easy case. Since it is a "T" and hence not
a closed device, it shouldn't cause obstruction(except from any adhesions
that might already have formed. So, in essence I don't think there is any
good answer to your question. Leaving it could cause problems. Removing it
could cause problems.
Dan
On Wed, Feb 25, 2009 at 3:16 PM, <jsbowpat@aol.com> wrote:
> My collaborative OB/GYN asked me to post this case and ask for listers'
> input ....
>
> A 35 yo G1P1, who has a guardian secondary to developmental disability, was
> referred to our office secondary to a "lost" copper-T IUD. The device was
> placed by another OB/GYN in 2004, and strings were not visualized on
> follow-up exam in 2005. At that time, it was found to be migrated to the
> RUQ, close to the spleen. The patient is not currently menstruating
> secondary to psych meds. She is not experiencing any abdominal pain at this
> time.
>
> Repeat CT of the abdomen and pelvis revealed the IUD lies just inferior to
> the distal colon in the left mid-abdomen. My partner's question - leave
> well enough alone or consider exploratory laparascopy to retrieve it? The
> general surgeon was consulted, and he was not helpful.
>
> Thanks!
>
> Susan Paterson CNM MS
> Center for Women's Care
> 835 S Main St., Suite 2
> Oconto Falls WI 54154
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--
R. Daniel Braun, MD FACOG(L) ABMP CMTh
Professor Emeritus
Dept. of Obstetrics and Gynecology
Indiana U. School of Medicine
--
R. Daniel Braun
“Science without Religion is LAME; Religion without Science is BLIND"
Einstein 1941
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It is my understanding that the copper can cause a lot of adhesions. For this reason, ot should probably be removed. However, since it has been there so long this might not be a very easy case. Since it is a "T" and hence not a closed device, it shouldn't cause obstruction(except from any adhesions that might already have formed. So, in essence I don't think there is any good answer to your question. Leaving it could cause problems. Removing it could cause problems. <br>
<br>Dan<br><br><div class="gmail_quote">On Wed, Feb 25, 2009 at 3:16 PM, <span dir="ltr"><<a href="mailto:jsbowpat@aol.com">jsbowpat@aol.com</a>></span> wrote:<br><blockquote class="gmail_quote" style="border-left: 1px solid rgb(204, 204, 204); margin: 0pt 0pt 0pt 0.8ex; padding-left: 1ex;">
My collaborative OB/GYN asked me to post this case and ask for listers' input ....<br>
<br>
A 35 yo G1P1, who has a guardian secondary to developmental disability, was referred to our office secondary to a "lost" copper-T IUD. The device was placed by another OB/GYN in 2004, and strings were not visualized on follow-up exam in 2005. At that time, it was found to be migrated to the RUQ, close to the spleen. The patient is not currently menstruating secondary to psych meds. She is not experiencing any abdominal pain at this time.<br>
<br>
Repeat CT of the abdomen and pelvis revealed the IUD lies just inferior to the distal colon in the left mid-abdomen. My partner's question - leave well enough alone or consider exploratory laparascopy to retrieve it? The general surgeon was consulted, and he was not helpful.<br>
<br>
Thanks!<br>
<br>
Susan Paterson CNM MS<br>
Center for Women's Care<br>
835 S Main St., Suite 2<br>
Oconto Falls WI 54154<div><br><font style="color: black; font-family: arial,san-serif; font-style: normal; font-variant: normal; font-weight: normal; font-size: 10pt; line-height: normal; font-size-adjust: none; font-stretch: normal;"> <hr style="margin-top: 10px;">
Looking for work? <a href="http://jobs.aol.com/?ncid=emlcntuscare00000001" target="_blank">Get job alerts, employment information, career advice and job-seeking tools at AOL Find a Job</a>.</font> </div>
</blockquote></div><br>
FACOG(L) ABMP CMTh<br>Professor Emeritus<br>Dept. of Obstetrics and Gynecology<br>Indiana U. School of Medicine<br><br><br>R. Daniel Braun<br><br> “Science without Religion is LAME; Religion without Science is BLIND"<br>
Einstein 1941<br>
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