Twice-failed tubal ligation: a case report
Ruminjo, J.K.; Chabari, C.
East African Medical Journal 70(8): 528-530
1993
ISSN/ISBN: 0012-835X PMID: 8261978 Document Number: 335026
A case of 2 failed tubal ligations in a para 6 Kenyan woman is described. She had an interval laparoscopic sterilization with silastic rings after delivery of her 6th child at age 38. After 3 menstrual periods she became pregnant. She decided to be sterilized again after delivery of her 7th child, a 3.5 kg male. Because of moderate obesity, a minilaparotomy with intravenous anesthesia was performed. The right fallopian tube was only partially occluded with a silastic ring, but the left tub was properly occluded. A Pomeroy tubal ligation was done, excising 2 cm of each tube, and ligating with No. 1 catgut. The woman experienced 2 more menses, and conceived again. She was delivered of a term female, and submitted to a hysterosalpingogram, which showed a tubal-peritoneal fistula on the right. The woman expressed fatalism about future childbearing, and eventually refused to return for contraceptive care or another sterilization.