Isolated fallopian tube torsion in an adolescent: a diagnostic challenge

Authors

  • Leonor Bivar Department of Gynaecology and Obstetrics, Hospital de Braga, Braga, Portugal
  • Ana Castro Department of Obstetrics and Gynaecology, Hospital de Braga, Braga, Portugal
  • Neusa Teixeira Department of Obstetrics and Gynaecology, Hospital de Braga, Braga, Portugal

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20205794

Keywords:

Isolated tubal torsion, Gynaecology surgery, Pediatric

Abstract

Torsion of the fallopian tube without ovarian involvement is an extremely rare event and often difficult to diagnose, but noteworthy, cause of lower abdominal pain. The authors describe a case related to a 14- year-old adolescent with acute lower abdominal pain and vomiting presented to the gynaecological emergency department. Blood tests exhibited modest biochemical parameters of inflammation and a transvaginal ultrasound showed a left adnexal tubular cystic mass with normal ovarian appearance. A diagnostic laparoscopy revealed an isolated fallopian tube torsion. The tube was able to be untwisted with restoration of pelvic anatomy and the follow-up was uneventful. The authors describe a challenging diagnosis in an adolescent in which delayed intervention could compromise her reproductive future. Tubal torsion should however be kept in mind in the differential diagnosis of lower abdominal pain in women of all ages.

References

Sanfilippo JS, Rock JA. Surgery for benign disease of the ovary. In: TeLinde's Operative Gynecology, 11th ed., Jones HW, Rock JA (Eds), Wolters Kluwer. 2015.

Bland-Sutton J. Salpingitis and some of its effects. Lancet 2. 1890;1146-8.

Comerci G, Colombo FM, Stefanetti M, Grazia G. Isolated fallopian tube torsion: a rare but important event for women of reproductive age. Fertil Steril. 2008;90(4):1198.e23-5.

Tsafrir Z, Hasson J, Levin I, Soloman E, Lessing JB et al. Adnexal torsion: cystectomy and ovarian fixation are equally important in preventing recurrence. Eur J Obstet Gynecol Reprod Biol. 2012;162:203-5.

Ziogas AC, Thanasas IK, Oikonomou IT, Tsiamanta C. Torsion of the left fallopian tube without ovarian involvement in a 47-year-old woman: A case report. Case Reports in Women's Health 26. 2020;e00179.

Richard HM, Parsons RB, Broadman KF, Shapiro RS, Yeh HC. Torsion of the fallopian tube: progression of sonographic features. J Clin Ultrasound. 1998;26:374-6.

Ssi-Yan-Kai G, Rivain AL, Trichot C, Morcelet MC, Prevot S, Deffieux X et al. What every radiologist should know about adnexal torsion. Emerg Radiol. 2018;25(1):51-9.

Jones HW, Jones GS. Novak Textbook of Gynecology, 10th ed, Wolters Kluwer Lippincott Williams & Wilkins, Baltimore. 1981;471.

Oelsner G, Cohen SB, Soriano D, Admon D, Masiach S, Carp H. Minimal surgery for the twisted ischaemic adnexa can preserve ovarian function. Hum Reprod. 2003;18:2599.

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Published

2020-12-26

Issue

Section

Case Reports