Small Bowel Obstruction Secondary to Migration of Tubal Ligation Clips: A Case Report.

A 72-year-old female presented with acute abdominal pain, vomiting, and obstipation, suggestive of a small bowel obstruction (SBO). Her surgical history included an open tubal ligation performed over four decades earlier. On examination, the patient had a distended abdomen with tenderness, particularly in the right lower quadrant. Computed tomography (CT) revealed multiple dilated small bowel loops with a transition point in the pelvis. Although tubal ligation clips were observed on CT in this region, they were not initially considered a contributing factor. Conservative management failed to resolve the obstruction, leading to the need for emergent laparotomy. Intraoperatively, two tubal ligation clips were found to have eroded into the small bowel, creating an adhesional band resulting in the SBO. The clips had also induced a bowel stricture, necessitating resection and subsequent anastomosis. This case and the accompanying images illustrate a rare cause of SBO due to the migration of tubal ligation clips. This emphasizes the importance of a comprehensive surgical history and the potential for clip migration to contribute to adhesional SBO, which may be resistant to conservative treatment.