Intractable pelvic pain following Filshie clip application.

Presented is the case of a 37-year-old South Australian woman who experienced intractable pelvic pain following laparoscopic sterilization with Filshie clips. The pelvic anatomy was normal and one Filshie clip was applied to each Fallopian tube. The patient stated she had experienced right-sided lower abdominal pain that radiated down the anterior part of her right thigh since regaining consciousness after general anesthesia. The pain had failed to resolve seven days after the procedure and the patient was unable to perform even simple tasks. Analgesics provided only temporary partial relief. There were no signs of infection or any other exacerbating condition. At diagnostic laparoscopy instillation of bupivacaine around the clip provided transient relief but the pain returned the next day at the same level of severity. After one month of intractable pain laparoscopic bilateral salpingectomy was performed to remove the clips and the pain disappeared. Although back pain has been reported in up to 14% of women undergoing laparoscopic sterilization this is the first published case of long-term abdominal pain associated with the Filshie clip.