title: Management of perforated essure with migration into small and large bowel mesentery.
abstract: The Essure permanent birth control system (Conceptus Inc, San Carlos, CA) is currently the only Food and Drug Administration-approved hysteroscopic sterilization method and has been widely accepted as a safe and effective procedure. We present a rare case of tubal perforation, coil fragmentation, and distal migration into small and large bowel mesentery 8 days after the insertion of the Essure device. We describe the successful management of this complication using laparoscopy and intraoperative fluoroscopy. Providers using Essure must be aware of the possibility of fragmentation of the Essure coils. Intraoperative imaging, ideally fluoroscopy, should be strongly considered in the management of Essure migration to ensure localization and full retrieval of Essure material.
authors.affiliation: Advocate Illinois Masonic Medical Center, Chicago, Illinois. Electronic address: Lena.Braginsky@advocatehealth.com.
authors.forename: Lena
authors.initials: L
authors.lastname: Braginsky
authors.affiliation: Advocate Illinois Masonic Medical Center, Chicago, Illinois.
authors.forename: Sean T
authors.initials: ST
authors.lastname: George
authors.affiliation: Advocate Illinois Masonic Medical Center, Chicago, Illinois.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Locher
mesh_terms: D000328:Adult; D005187:Fallopian Tubes / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D058736:Intrauterine Device Migration; D007434:Intrauterine Devices / Q000009:adverse effects; D010535:Laparoscopy / Q000379:methods*; D008643:Mesentery / Q000000981:diagnostic imaging*; D012421:Rupture; D058994:Salpingectomy / Q000379:methods; D013246:Sterilization, Tubal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: Essure; Fluoroscopy; Laparoscopy; Tubal perforation