A 45-year woman, carrying an IUD for 2 years, was referred to our emergency unit for pelvic pain and bleeding. At vaginal examination, the strings of the IUD were not identified. Laboratory parameters were unremarkable. The abdominal radiography documented the presence of IUD in the abdominal cavity (FIG.1). During laparoscopy, the surgeon was unable to localize the IUD and an intraoperative ultrasound examination was requested. Using a sterile transabdominal probe the presence of a tubular hyperechoic structure in the abdominal cavity was confirmed and a precise localization within the bowel loops was defined (FIG 2 and Video 1). This article is protected by copyright. All rights reserved.