An unusual case of migration of Filshie clip.

©FFPRHC J Fam Plann Reprod Health Care 2007: 33(3) Case report A 53-year-old woman presented with a 4-week history of constant pain and a lump in the right groin. She also gave a history of low-grade fever, loss of weight and general malaise. There was no history of vaginal discharge or urinary symptoms. She was a housewife and had been in the same relationship for 19 years. The only relevant past history was that she had undergone laparoscopic sterilisation with Filshie clips 13 years previously. There was no history of recent surgery. On admission to hospital she had a low-grade pyrexia. An exquisitely tender 5 cm diameter indurated mass was present in the right groin. Vaginal examination revealed marked right adnexal tenderness. The clinical impression was that of a lymph node mass or a psoas abscess. She was admitted and started on antibiotics. Investigations revealed a moderate neutrophil leucocytosis. Abdominal X-ray showed a sterilisation clip projected over the medial aspect of the right femoral head. The left clip appeared to be normally located. This was confirmed on a computed tomography (CT) scan, which revealed a right iliac fossa inflammatory lesion, possibly a tubal abscess, intimately related to the right tubal clip. There was no abdominal or pelvic lymphadenopathy. Her pyrexia persisted and in view of the CT findings consent was obtained for exploratory laparotomy. This showed a right-sided extraperitoneal abscess containing 400 ml pus. A Filshie clip was seen in the abscess cavity. There was no pus in the abdominal cavity. Both Fallopian tubes were adherent to the anterior abdominal wall. There was a 5 cm unilocular right ovarian cyst, which was also stuck to the anterior abdominal wall. The left ovary was normal. A Filshie clip was seen appropriately placed on the left Fallopian tube. The abscess was drained and a right ovarian cystectomy was performed. The patient made an uncomplicated postoperative recovery. Histology showed a benign ovarian serous cystadenoma. There was a thickened area at the base of the cyst, which contained multiple small abscesses. Special stains for bacteria, yeasts, fungi and tubercle bacilli were negative. An unusual case of migration of Filshie clip