Intraperitoneal Coil Migration Causing Appendicular Bisection Treated By Laparoscopic Appendectomy: A Call for Alternatives
Atef MM Darwish*, Dina AM Darwish and Ahmed Dervis
Applied Medical Research. 2022;
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
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.