Intrauterine devices (IUDs) have been plagued by many early and late complications, including uterine perforation and subsequent migration into adjacent structures. Perforation of the uterus by an IUD is a serious complication occurring in approximately 1 of 350 to 1 of 2,500 insertions. It is more common among older women with "lost" IUDs. This case illustrates that unusual phenomenon that a lost IUD can penetrate into the omentum. We herein report a case of acute peritonitis and pneumoperitoneum with perforation of the uterus associated with a lost IUD and perforation of a malignancy of the sigmoid colon.
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