Intrauterine and ectopic pregnancies after a tubal ligation with documented tubal occlusion

The patient described had both an intrauterine and an extrauterine pregnancy after a previous vaginal tubal ligation using a Pomeroy technique. A hysterosalpingogram showed midtubal occlusion. Although pregnancy after tubal ligation is not unusual, this case does show that a hysterosalpingogram may also be inconclusive in ruling out the possibility of future pregnancy.