How did a prosthetic femoral head migrate to the mesorectum?

Description 

This 64-year-old man underwent a total hip replacement for osteoarthritis via a posterior approach. Day 1 postoperatively, he felt his hip click while turning into a chair. X-ray revealed an anterior hip dislocation with the prosthetic femoral head disengaged and migrated into the pelvis. CT demonstrated the ceramic head was retroperitoneal, anterior to the right iliac bone within the iliopsoas muscle interval (figure 1). His case was discussed with hip revision and trauma specialists with a provisional plan to revise the hip replacement and remove the femoral head. The patient, however, did not wish invasive, intra-abdominal surgery and requested a limited approach for implant retrieval. Revision hip surgery was performed with anteversion of the acetabular component adjusted; retrieval of the femoral head was not possible through this approach. A further attempt via a minimally invasive, retroperitoneal approach along the inner table of pelvic wall was...

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