This case involves a female patient who initially wanted to use Essure as a permanent form of contraceptive, but changed her mind and underwent a tubal ligation at a local community hospital instead. The procedure was performed by her private gynecologist and shortly after the procedure, the patient experienced a severe episode of nausea and projectile vomiting. Three days after the procedure, the patient saw her gynecologist who suspected that there was a hematoma in the lower quadrant of the abdomen. The patient was sent back to the hospital where she was admitted for a suspected small bowel obstruction. After being closely followed and treated conservatively with NG tube decompression and slow advancement of a liquid diet, the decision was made to discharge the patient after she had a bowel movement. No scans or confirmatory tests were performed upon discharge. The patient was discharged after a 10-day hospital stay despite the fact that she was continuing to feel ill. Two weeks later, the patient underwent a CT scan for complaints of abdominal pain and the imaging revealed the presence of a hernia. The patient was sent for surgery which identified a significant amount of incarcerated necrotic bowel that was resected due to strangulation.
