Case notes
A 59-year-old woman, gravida 3, para 2, had a 7-month history of metrorrhagia. Her obstetric history included 1 cesarean section and 1 abortion. She was overweight with a body mass index of 28, and she had a 29-year history of psoriatic arthritis, which had been treated with cyclosporine and methotrexate until 2 months before her referral to our hospital for further investigation of her bleeding. Menopause started 9 years earlier.
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A routine examination was followed by abdominal and vaginal ultrasonography. Imaging showed hyperechogenic spots in the uterine cavity ( Figure 1 ). Subsequent hysteroscopy highlighted the presence of a tubular blue foreign body that resembled a thread ball ( Figures 2 and 3 ). Progression with an instrument suggested the object had features consistent with a retained permanent suture ( Video ).
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