Case 1:I was referred a patient by a colleague because he could not locate her levonorgestrel-releasing intrauterine contraceptive on physical exam or by pelvic ultrasound. The patient desired a pregnancy, and conception would require removal of the device. When it was not visualized on examination or by ultrasound, my colleague performed a laparoscopy, but it was not seen in the pelvis. I obtained a pelvic X-ray that showed the IUD outside the uterus on the left side of the pelvis. I wonder, could the IUD have been in the broad ligament all along and that is why my colleague did not see it on laparoscopy or ultrasound? Or might it have migrated further since her laparoscopy and if I bring her back to surgery might I be able to retrieve it? Would an MRI help?
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