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December 27, 1965

Intrauterine Contraceptives: An Unusual Complication

Author Affiliations

From the Department of Surgery, Rockford Memorial Hospital, Rockford, Ill.

JAMA. 1965;194(13):1385. doi:10.1001/jama.1965.03090260045018

INTRAUTERINE contraceptive devices have provoked controversy over their mode of action, efficacy, and side effects. Perforations of the uterine wall are apparently rare, but there are reported cases in which a ring has been found outside the uterus accompanied by few or relatively minor symptoms.1 Tietze and Lewit2 reported, in a study of 23,602 cases, that there were 24 uterine perforations. Seventeen of these involved the Birnberg bow. Price3 reported a case in which a Gräfenberg ring had eroded through some two thirds of the uterine wall and a loop of ileum had passed through the ring resulting in intestinal obstruction. Our case is similar to the one reported by Price.

Report of a Case  A 33-year-old woman was admitted to Rockford Memorial Hospital on July 31, 1965, because of acute abdominal pain which began in the epigastrium approximately seven hours prior to admission. This pain became