引言：因腹腔内子宮内避孕器（Intrauterine device, IUD)而導致子宮穿孔且需要 諮詢外科醫師的狀況不常見。無論症狀輕微或嚴重與否，因子宮穿孔而移位的子宮内 避孕器，都需要立即進行手術取出，以避免造成進一步的腸穿孔或腸阻塞等併發症。 以下案例是一個藉由腹腔鏡手術將子宮内避孕器取出的個案。 案例：本個案的是一名28歲的女性，在植入蜜蕊娜子宮内避孕器（levonorgestrel IUD-Mirena)後不久開始出現陰道點狀出血症狀，並持續了 6個月。我們藉由陰道超 音波，骨盆攝影和骨盆腔電腦斷層掃描等檢查來定位子宮内避孕器所在點。定位完成 後既進行腹腔鏡手術，安全的將子宮内避孕器取出。 結論：腹腔内子宮内避孕器造成的子宮穿孔，多數是由婦科醫師診斷出來，但有 時會遇到需要進一步諮詢一般外科醫生的情況。此時我們建議安排骨盆腔攝影和骨盆 腔電腦斷層掃描，以確認鄰近器官是否受到影響或穿孔。對於大多數情況，腹腔鏡移 除術是可行並且有利的。

Introduction： Uterine perforation with an intra-abdominal intrauterine device (IUD) resulting in consultation to a general surgeon is rare. However, migrated IUD due to uterine perforation, regardless of the severity of symptoms, should be promptly removed surgically to avoid further bowel perforation or obstruction. We report a case of intra-abdominal IUD utilizing laparoscopic removal. Case： A 28-year-old woman who suffered from vaginal spotting for six months following levonorgestrel IUD (Mirena®, Bayer, Leverkusen, Germany) implantation. An initial diagnostic workup, including the performance of a transvaginal ultrasound, pelvis X-ray, and pelvic computed tomography (CT) scan, was completed to localize the IUD. Then, laparoscopy was performed to remove the device smoothly. Conclusions： Intra-abdominally-located IUDs due to uterine perforation are usually diagnosed by gynecologists, but further consultation to general surgeons can be encountered sometimes. Imaging studies such as pelvic X-ray or abdominal CT are recommended to assess adjacent organ involvement or perforation. Laparoscopic extraction are feasible and beneficial in most cases.