子宫内节育器移位至上腹部网膜1例罕见病例报道

A Rare Case Report of an Intrauterine Device That Has Shifted into the Upper Abdominal Omentum

摘要: 宫内节育器(IUD)是一种常用的长效可逆避孕方式，但长期留置可能引发严重并发症。本文报告一例75岁女性因反复上腹痛入院，经CT检查发现肝脏前方有环形金属异物，结合病史推测为移位的节育器。患者于48年前置入IUD，之后未取出。在腹腔镜手术中，于右上腹部大网膜中发现节育器并成功摘除。术后恢复顺利，无明显不适。该病例提示，节育器可发生远距离移位且可能长期无明显症状，易被误诊漏诊。影像学检查在明确诊断中具有重要价值，腹腔镜是安全有效的治疗手段。临床应加强节育器随访管理，特别是对高龄及长期留置患者，及早发现并处理潜在并发症。

Abstract: The intrauterine device (IUD) is a commonly used long-acting reversible contraceptive method, but prolonged retention can lead to serious complications. This report presents a case of a 75-year-old woman admitted for recurrent upper abdominal pain. CT imaging revealed a ring-shaped metallic foreign body anterior to the liver, which, combined with her medical history, was suspected to be a displaced IUD. The patient recalled an IUD insertion 48 years ago, which had never been removed. During laparoscopic surgery, the IUD was found encapsulated in the greater omentum of the right upper abdomen and was successfully extracted. Postoperative recovery was uneventful. This case highlights that IUDs can migrate long distances and remain asymptomatic for extended periods, increasing the risk of misdiagnosis. Imaging plays a crucial role in diagnosis, and laparoscopy is a safe and effective treatment option. Regular follow-up is essential, especially in elderly patients or those with long-term IUD retention, to detect and manage potential complications early.