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  • Title: Retained Graefenberg ring intrauterine device mimicking fractured Lippes loop in-utero.
    Author: Goh Tai Heng, Kuan BB.
    Journal: Med J Malaysia; 1985 Mar; 40(1):44-5. PubMed ID: 3831735.
    Abstract:
    This article reports a case of a retained Grafenberg IUD, which on pelvic radiography resembled a fractured Lippes Loop. The patient, a 52-year-old Chinese woman, had been fitted with a ringlike IUD 20 years earlier. 3 years after insertion, she had a miscarriage and was informed that the IUD had probably been expelled. At presentation, this patient had a 3-week history of menorrhagia. She was not anemic and systemic examination failed to reveal any abnormalities. Radiography revealed a linear radio-opague foreign body in the pelvis that looked like part of a fractured Lippes Loop. After uterine curettage, the foreign body was retrieved with difficulty and in fragments. Histopathologic examination of the endometrial cuttings showed cystic glandular hyperplasia with no evidence of malignancy or inflammation. In this case, embedment of the IUD had reduced contraceptive efficacy and made removal problematic. The force required to retrieve the device and the straightening out of its coils during the process indicate that there could have been a type 1 or 2 uterine perforation. It is assumed that the Grafenberg ring was broken and splayed out during a prior uterine curettage.
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