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International Scientific Indexing (ISI) Indexed Journal Applied Medical Research ISSN: 2149 - 2018
Applied Medical Research. 2022; 9(2):(131-159)

Intraperitoneal Coil Migration Causing Appendicular Bisection Treated By Laparoscopic Appendectomy: A Call for Alternatives

Atef MM Darwish*, Dina AM Darwish and Ahmed Dervis

Objective: To describe the clinical presentation, laparoscopic findings, and management of a case of intraperitoneal migration of a copper coil with appendicular bisection and to highlight alternative approaches to avoid this serious complication. Design: A case report. Setting. Endoscopy Unit of a tertiary University hospital. Patients: A multiparous woman presented with chronic pelvic pain. Interventions: Transvaginal ultrasonography revealed a uterus free of the coil that was proved to be intraabdominal by a plain X-ray film. Diagnostic/operative laparoscopy was done with dissection of the right adnexa from the bladder and the appendix. The appendix was bisected that required laparoscopic appendectomy. Main Outcome Measures: Efficacy of endoscopic management of appendicular involvement by a migrating coil. Results: Laparoscopy was very effective in the diagnosis and management of appendicular bisection by a migrating copper coil. Conclusions: Chronic pelvic pain in women wearing a coil should be meticulously assessed. Serious sequel of the migrating coil should be managed by an experienced endoscopic surgeon. Coil insertion techniques and follow-up visits should follow strict guidelines to prevent serious complications that must be included in the insertion counselling.