Presentation
Incidental finding. The patient presents with acute chest pain.
Patient Data
Unremarkable chest X-ray and rib views.Incidental finding of bilateral, symmetric, subphrenic or subdiaphragmatic metallic sterilization clips.
Subphrenic sterilization clips
At first glance, one may easily be fooled into thinking of an unusual, symmetric, breast clip or "ring" etc.
On lateral review, there is confirmation of posterior, dual, symmetric, subphrenic sterilization clips
Case Discussion
Sterilization clips may be "dropped" during laparoscopic tubal ligation surgery. There are often eccentrically located within the pelvis in these instances. Occasionally the metallic clips have "migrated" and identified incidentally extra pelvic on abdominal or chest radiographs performed for other reasons. It is uncertain how these clips migrate to these extrapelvic sites, however, it may possibly be due to the movement of normal physiological peritoneal fluid flow. This theory accounts for the explanation of peritoneal seeding of pelvic malignancies and also endometrial deposits within the abdomen and pelvis. The migrated sterilization clips usually remain inert and asymptomatic however diaphragmatic irritation can occur when the clips are immediately subdiaphragmatic.
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