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Extruded Filshie clip presenting as an ischiorectal abscess
R Sascha Dua1, Michael J Dworkin
1Department of Surgery, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, Essex, UK. saschadua@hotmail.com
Annals of the Royal College of Surgeons of England
|November 15, 2007
Summary
Tubal clip migration is a rare complication of laparoscopic sterilization. Women experiencing persistent peri-anal sepsis should be evaluated for this possibility, which has medicolegal implications.
Area of Science:
- Gynecology
- Surgical Complications
- Medical Device Migration
Background:
- Laparoscopic sterilization is a common surgical procedure for permanent contraception.
- Late complications, though infrequent, can occur following this procedure.
- Recalcitrant peri-anal sepsis is a challenging clinical presentation.
Observation:
- A case is presented highlighting a late complication of laparoscopic sterilization.
- The complication involved the migration of a tubal clip.
- This led to recurrent peri-anal sepsis in the patient.
Findings:
- Tubal clip migration can occur long after laparoscopic sterilization.
- This migration can manifest as severe and persistent peri-anal sepsis.
- The physical presence and migration of the clip are the direct cause of sepsis.
Implications:
- Clinicians should consider tubal clip migration in women with unexplained peri-anal sepsis post-sterilization.
- This diagnosis requires careful patient counseling regarding sterilization efficacy.
- Medicolegal aspects are crucial, necessitating thorough investigation and documentation.
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