Subserosal misplacement of Essure ∗ device manifested by late-onset acute pelvic pain

Abstract

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). Case report. University-affiliated teaching hospital. 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. Hysterosalpingogram showing patency of the left fallopian tube and operative laparoscopy. Laparoscopic removal of the Essure device with left salpingectomy. The patient was free of pain and was discharged home the same day of the laparoscopic procedure. 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.