Department of Obstetrics and Gynaecology, Ealing Hospital NHS Trust, London, United Kingdom.
Fertil Steril. 2011 Jun;95(7):2429.e15-7. doi: 10.1016/j.fertnstert.2011.02.006. Epub 2011 Mar 2.
To highlight the fallacy of using a kink in the microinsert outline on plain abdominal x-ray as a marker for tubal perforation.
Case report.
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.
强调将微插入物轮廓上的弯曲视为输卵管穿孔标记物的谬误。
病例报告。
伦敦西部区域综合医院。
要求永久性绝育的 36 岁亚裔女性。
Essure 宫腔镜绝育术，随后进行腹部 X 光、盆腔超声和腹腔镜检查。
无输卵管穿孔。
患者在 Essure 宫腔镜绝育术后 3 天出现疑似输卵管穿孔的临床症状。她的经阴道超声检查结果不确定，但 X 光片显示左侧微插入物轮廓上有一个弯曲。诊断性腹腔镜检查未发现穿孔，输卵管切除术确认双侧输卵管放置位置正常。
该病例强调了在宫腔镜绝育术后的急性情况下，依靠影像学来确诊输卵管穿孔的困难。
