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E1208. An IUD: Here I Belong, But Where Do I Go?
Authors
  1. Randy Chang; UCLA
  2. Shaden Mohammad; Olive View-UCLA Medical Center
  3. Soni Chawla; Olive View-UCLA Medical Center
Background
Intrauterine devices (IUDs) are one of the most widely used forms of contraception available. However, complications can arise during which the IUD migrates from its ideal position at the uterine fundus. Evaluation of IUD position can be clinically challenging. The migration of IUDs can have a significant morbidity and mortality if the entity is not diagnosed properly in a timely manner. Appropriate imaging can greatly aid in the diagnosis of these complications, which include uterine expulsion, displacement from the ideal IUD position, embedment into the myometrium, and uterine perforation. Each complication has varying clinical significance and different management guidelines that may require direct communication with a clinician. This exhibit will give an overview of relevant normal anatomy of IUD placement for better recognition of migration. In addition, background will be provided for the different types of IUDs. Using a multimodal imaging approach, the exhibit will also present multiple common and uncommon cases of IUD migration and illustrate the key imaging findings of the different complications.

Educational Goals / Teaching Points
This educational exhibit will provide common and uncommon complications of IUD migration, including expulsion, displacement, embedment, and perforation. Using a multimodal imaging approach, it will present multiple cases that illustrate the key imaging findings of emergent and non-emergent conditions. A brief overview of the relevant normal anatomy of IUD placement, risk factors, clinical presentation, diagnostic workup, and management, will also be included.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Multiple complications can arise from IUDs, including expulsion, displacement, embedment, and perforation. It is therefore important for the radiologist to be familiar with the radiologic manifestations of the many types of IUD translocation, so that timely diagnostic workup and management can be initiated. The imaging findings of IUD migration include but are not limited to the IUD being partially embedded in the myometrium, or being visualized in a uterine horn, lower uterine segment, cervical canal, vaginal canal, and intra-abdominal cavity.

Conclusion
The diagnosis of IUD migration is challenging. Review of the common imaging findings of IUD migration using multiple modalities while understanding the corresponding appropriate management can significantly help the physician to better treat patients and decrease complications.