title: Subserosal misplacement of Essure device manifested by late-onset acute pelvic pain.
abstract: 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).
  
  
  METHODS
  Case report.
  
  
  METHODS
  University-affiliated teaching hospital.
  
  
  METHODS
  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.
  
  
  METHODS
  Hysterosalpingogram showing patency of the left fallopian tube and operative laparoscopy.
  
  
  METHODS
  Laparoscopic removal of the Essure device with left salpingectomy.
  
  
  RESULTS
  The patient was free of pain and was discharged home the same day of the laparoscopic procedure.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, University of Illinois at Rockford, Rockford, Illinois, USA.
authors.forename: Mohamad S
authors.initials: MS
authors.lastname: Mahmoud
authors.forename: Dmitry
authors.initials: D
authors.lastname: Fridman
authors.forename: Zaher O
authors.initials: ZO
authors.lastname: Merhi
mesh_terms: D000328:Adult; D003273:Contraceptive Devices / Q000009:adverse effects*; D020878:Device Removal; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D010535:Laparoscopy; D010149:Postoperative Pain / Q000209:etiology / Q000601:surgery; D017699:Pelvic Pain / Q000209:etiology* / Q000601:surgery*; D013245:Sterilization, Reproductive / Q000009:adverse effects* / Q000295:instrumentation