Intrauterine contraceptive device (IUCD) has become widely used between childbearing age group for birth control. However we
might face displacement of IUCD, which may lead to migration of IUCD extra-uterine and eventually perforation, will take a place.
We reported a 34 years old lady (p3+1) presented to emergency department with heavy per vaginal bleeding after 2 months of
missing period. Vaginal examination revealed opened os with clots. IUCD was not seen in Ultrasound examination. Computerized
Tomography scan (CT) was done on next day and showed that the missed IUCD was outside the uterus in the pelvic. Laparoscopy
identified the thread and the rest of the device was inside the rectum .the device was pulled through rectum by long artery forceps
with no significant rent felt. Conclusively, IUCD is a safe method for contraception but perforation and migration could happen and
it is important to do rectal exam along with other investigations if needed and it could be safely removed through the rectum
without complications or the need of colostomy.
Keywords: Intra-uterine contraceptive device, perforation, rectum, Laparoscopy, colostomy.