Fertility and sterility · 2011
A kink is not always a perforation: assessing Essure hysteroscopic sterilization placement.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Borley Jane, Shabajee Natasha, Tan Toh Lick
Аннотация
OBJECTIVE: To highlight the fallacy of using a kink in the microinsert outline on plain abdominal x-ray as a marker for tubal perforation.
DESIGN: Case report.
SETTING: West London District general hospital.
PATIENT(S): 36-year-old Asian woman requesting permanent sterilization.
INTERVENTION(S): Essure hysteroscopic sterilization followed by abdominal x-ray, pelvic ultrasound, and laparoscopy.
MAIN OUTCOME MEASURE(S): Absence of tubal perforation.
RESULT(S): A patient presented with clinically suspected fallopian tube perforation 3 days after Essure hysteroscopic sterilization. Her transvaginal scan was inconclusive, but the plain x-ray demonstrated a kink within the left microinsert outline. Diagnostic laparoscopy did not identify a perforation, and bilateral tubal placement was confirmed after salpingectomy.
CONCLUSION(S): This case highlights the difficulty of relying on imaging in the acute setting to establish a diagnosis of tubal perforation after hysteroscopic sterilization.
DESIGN: Case report.
SETTING: West London District general hospital.
PATIENT(S): 36-year-old Asian woman requesting permanent sterilization.
INTERVENTION(S): Essure hysteroscopic sterilization followed by abdominal x-ray, pelvic ultrasound, and laparoscopy.
MAIN OUTCOME MEASURE(S): Absence of tubal perforation.
RESULT(S): A patient presented with clinically suspected fallopian tube perforation 3 days after Essure hysteroscopic sterilization. Her transvaginal scan was inconclusive, but the plain x-ray demonstrated a kink within the left microinsert outline. Diagnostic laparoscopy did not identify a perforation, and bilateral tubal placement was confirmed after salpingectomy.
CONCLUSION(S): This case highlights the difficulty of relying on imaging in the acute setting to establish a diagnosis of tubal perforation after hysteroscopic sterilization.