Computed tomographic confirmation of distally placed Essure∗ microinsert

Objective To highlight the use of CT scan to confirm proper placement of the Essure microinsert tubal occlusion device. Design Case report. Setting Community-based, outpatient setting. Patient(s) A 37-year-old woman (G2P2002) who desired permanent sterilization. Intervention(s) The patient underwent hysteroscopic placement of Essure microinserts, which was complicated by inability to confirm intraluminal placement of the left implant by hysteroscopic visualization. A CT scan performed that day confirmed intraluminal placement and ruled out intraperitoneal placement of the insert. Main Outcome Measure(s) Confirmation of correct insert placement. Result(s) A CT scan confirmed the placement of the Essure insert within the fallopian tube lumen and excluded perforation into the peritoneal cavity. Conclusion(s) Computed tomography is a reliable way to determine whether Essure microinserts are properly placed when this cannot be determined by hysteroscopic visualization. Follow-up hysterosalpingography continues to be required to confirm tissue ingrowth at 3 months' time.