Adnexal Torsion

Clinico-Pathological Profile of Adnexal Torsion Cases: A Retrospective Analysis from A Tertiary Care Teaching Hospital

“…The sonographic findings which may predict adnexal torsion are visualisation of a cystic, solid or complex mass at the location of the adnexal, cranial to the uterine fundus, thickening of the adnexal wall, unilateral ovarian enlargement, peripherally enlarged follicles, cystic hemorrhage and free pelvic fluid. The location of the torsed ovary is mediosuperior to its original location [10]. In many cases, it has been noted that in torsion adnexa, when the ovary is enlarged, the neoplasm has been found to be benign [3,[5][6][7][8][11][12].…”

Torsion of the Fallopian Tube and the Haematosalpinx in Perimenopausal Women- A Case Report

“…the mechanism of tubal torsion: [1], [7][8][9][10] In the presence of should be included in the differential diagnosis of an acute lower abdominal pain in women, especially in those with predisposing factors. An early diagnosis and an early intervention can maximize the tubal salvage.…”

“…A left salpingo-oophorectomy was done and it was sent for a histopathological examination (which was consistent with the fallopian tube with haemorrhage predisposing factors, the adnexal veins and the lymphatic vessel are prone to a mechanical blockage, leading to a local oedema and a pelvic congestion. The subsequent enlargement of the adnexa predisposes to a partial or a complete torsion, along with the formation of a hydrosalpinx [1,9,10]. If there is an associated compromise in the arterial supply, it leads to a haemorrhagic infarction and a haematosalpinx [1,5,11,12].…”

“…the clinical presentation: [1,8,10] Commonly, the patients present with a sudden onset of lower abdominal pain which is colicky in nature, which often radiates to the flank or thigh. On pelvic examination, a tender adnexal mass may be present, with a positive cervical motion tenderness .…”

“…Ultrasound [3,4,10] may reveal an elongated, convoluted, cystic mass which tapers as it nears the uterine cornu, with the typical beads-on-a string sign [14] and demonstration of the ipsilateral ovary as separate from the mass. Doppler may be helpful and it shows a high impedence or the absence or reversal of the diastolic flow (obstruction to the blood flow in a mesosalpinx) in a tubular structure, especially that in one with a history of tubal ligation can be indicative of a diagnosis [10]. A whirlpool sign may be specific of a tubal torsion, if it is elicited.…”