Subserosal misplacement of Essure device manifested by late-onset acute pelvic pain
Mohamad S Mahmoud1, Dmitry Fridman, Zaher O Merhi
1Department of Obstetrics and Gynecology, University of Illinois at Rockford, Rockford, Illinois, USA.
Objective:
To increase awareness of the potential to present with late-onset acute pelvic pain secondary to subserosal misplacement of an Essure device (Conceptus Inc., Mountain View, CA).
Design:
Case report.
Setting:
University-affiliated teaching hospital.
Patient(S):
A 30-year-old woman who was seen with severe left lower quadrant pain 4 months after elective sterilization with an Essure device placed under local anesthesia. Mild to moderate resistance was encountered in the placement of the device in the left fallopian tube.
Intervention(S):
Hysterosalpingogram showing patency of the left fallopian tube and operative laparoscopy.
Main Outcome Measure(S):
Laparoscopic removal of the Essure device with left salpingectomy.
Result(S):
The patient was free of pain and was discharged home the same day of the laparoscopic procedure.
Conclusion(S):
This report reinforces the need to consider a misplaced Essure device in the differential diagnosis of late-onset acute pelvic pain in women who had difficult placement of the device.
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