Adnexal Torsion after Isolated Salpingeal Torsion: An Undesired Complication of Conservative Management: A Case Report

Abstract

Objective: Isolated salpingeal torsion (IST) is a rare cause of acute abdomen in women of the reproductive age group. The lack of pathognomonic clinical, laboratory or radiographic findings makes early diagnosis a challenge. We describe a case of IST in a 13-year-old who suffered from a repeat torsion following initial conservative management.
 Case Report: A 13-year-old girl presented with acute right lower quadrant abdominal pain of insidious onset. Her past medical history was non-contributory and her initial workup was unremarkable. Exploratory laparoscopy subsequently revealed isolated torsion of the right fallopian tube which was detorted. She presented 10 months later with similar complaints and further workup demonstrated right adnexal torsion which was confirmed by laparoscopy; salpingo-oophorectomy was necessary due to gangrenous necrosis.
 Conclusion: Conservative management of fallopian tube torsion confers the advantage of fertility preservation but the risk of repeat torsion remains clinically significant.

A rare case of isolated fallopian tubal torsion in adolescent girls: A case report and system review of literature

“…We found 43 cases of IFTT in pubertal girls described in the English language literature in the past 21 years. 5–37 Recorded general characteristics including age, duration of abdominal pain (DAP), clinical manifestation, blood test, and image examination are shown in Table 1. And intraoperative and postoperative conditions of IFTT including preoperative diagnosis, size of the cyst, exploration mode of emergency operation, procedure, and routine pathology are also shown in Table 2.…”

“…And it is not recommended to perform salpingopexy to prevent recurrence, because it may reduce the reproductive function of fallopian tube. 27…”

“…: hydrosalpinx adjacent to the left ovary and no ascites (free fluids); B-U: left para-adnexal formation, and moderate amount of free fluid. 30 Ibirogba et al27 …”

Chronic Isolated Fallopian Tube Torsion in a Sexually Inactive Adolescent Female Diagnosed Peroperatively

“…Extrinsic factors include ovarian or paraovarian masses, pelvic adhesions, pelvic venous congestion, sudden body movement, and uterine enlargement. IFTT in adolescents is mainly associated with intrinsic causes [ 3 , 5 ], and tubal torsion occurs more frequently on the right side [ 5 ]. This tendency is reportedly caused by reduced mobility of the left tube owing to the sigmoid colon.…”

“…Almost 80% of IFTT cases are in fertile women, and it is a rare cause of acute abdomen premenarche [ 2 ]. In this group, congenital malformations are a possible risk factor for IFTT [ 3 ]. IFTT has various nonspecific symptoms; however, abnormal vaginal discharge has not been previously reported [ 1 ].…”