title: Spontaneous expulsion of tubal ligation clips: a case report.
abstract: BACKGROUND
  A rare complication of tubal ligation, expulsion of tubal clips has been sporadically reported in the literature.
  
  
  METHODS
  An otherwise well multiparous woman who had undergone two operative deliveries and a tubal ligation presented with menstrual discharge from her laparotomy incision. Following two surgical procedures to excise fistulous tracts, the patient spontaneously expelled three Hulka tubal ligation clips from the vagina.
  
  
  CONCLUSIONS
  Migration of tubal ligation clips and extrusion with associated tuboperitoneal fistula is a rare outcome of tubal ligation. Individual patient reactions to the presence of supposedly inert objects in the peritoneal cavity are unpredictable.
authors.affiliation: Department of Obstetrics and Gynecology, University of Manitoba, Winnipeg, MB.
authors.forename: Meriah
authors.initials: M
authors.lastname: Fahey
mesh_terms: D000328:Adult; D017577:Cutaneous Fistula / Q000209:etiology* / Q000601:surgery; D005184:Fallopian Tube Diseases / Q000209:etiology* / Q000601:surgery; D005260:Female; D005548:Foreign-Body Migration; D006801:Humans; D012008:Recurrence; D012086:Reoperation; D013246:Sterilization, Tubal / Q000009:adverse effects* / Q000295:instrumentation; D013525:Surgical Instruments / Q000009:adverse effects; D001745:Urinary Bladder Diseases / Q000209:etiology* / Q000601:surgery; D014548:Urinary Fistula / Q000209:etiology* / Q000601:surgery; D014621:Vagina