Migration of a Fallopian Tube Clip Into a Femoral Hernial Sac

Tubal ligation clip migration is a recognized late complication of sterilization, although symptomatic presentations are uncommon.We report a case of an 85-year-old woman with a remote history of bilateral tubal ligation who presented with several days of right groin pain and a gradually enlarging lump.CT of the abdomen and pelvis demonstrated a right femoral hernia sac containing fat, a small volume of fluid, and a 13 mm metallic clip.The right-sided tubal ligation clip was also visualized in its expected pelvic position, confirming that the clip within the right femoral hernia originated from the left side and had migrated across the pelvic midline.There was no evidence of bowel obstruction or strangulation.The patient underwent open repair of the right femoral hernia through an inguinal approach, during which the migrated clip was removed.Whether the clip contributed to hernia formation or became incidentally lodged within a preexisting hernia remains uncertain.This case highlights the importance of considering prior tubal sterilization when evaluating unexpected metallic foreign bodies within the pelvis or groin.Cross-sectional imaging may assist in characterizing hernia contents and identifying migrated clips when clinically indicated.