子宮内避妊器具による骨盤内感染によりS状結腸狭窄をきたした1例

Abstract

A 49-year-old woman was seen at a practitioner because of fever and increasing abdominal distension. She had an intrauterine device (IUD) inserted at the age of 31 and she had let it alone without exchange thereafter. Barium enema study showed a severe stenosis of the sigmoid colon. Colonoscopy showed a narrowed lurnen with evident edema of mucosa but no mucosal erosion or ulcer was detected. Tumor of the left ovary was suspected on abdominal CT and sent to the department of gynecology in our hospital. At laparotomy, the left adnexa was swollen forming a mass which was firmly adhered to the sigmoid colon whose wall showed inflammatory hypertrophy. A total hysterectomy, an adnexectomy, and a sigmoidectomy were carried out. On the resected material, the IUD was identified in the lumen of the uterine. Histopathologically granuloma was prominent at the left adnexa. From these findings, we diagnosed that the inflammation of the left adnexa infiltrated to the sigmoid colon.