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October 8, 1982

Uterine Perforation by Intrauterine Devices

JAMA. 1982;248(14):1710. doi:10.1001/jama.1982.03330140024019

To the Editor.—  David Zakin, MD, and colleagues described the clinical and radiological workup of perforated and embedded intrauterine devices (IUDs) in a recent issue of The Journal (1982;247:2144). They stated that the procedure of choice for demonstrating uterine perforation by an IUD is hysterosalpingography (HSG).I agree that in some cases HSG may be the only definitive way to demonstrate a partial perforation. However, computed tomography (CT) is also capable of identifying uterine perforation by an IUD. Two colleagues and I1 recently reported such a case. The patient was positioned in the scanner by means of a digital scout view of the pelvis. The accuracy of this method of positioning allowed us to definitely diagnose a perforation after a single CT "slice." Not only is CT a speedier examination than HSG, but it is also less invasive, more comfortable to the patient, and delivers a lower gonadal radiation