Isolated fallopian tube torsion associated with hydrosalpinx in a 12-year-old girl: a case report

Abstract

Background Isolated fallopian tube torsion associated with hydrosalpinx is a rare condition in the pediatric population. We present this unusual clinical case study in a sexually inactive girl. Case presentation a12-year-old Caucasian girl presented symptoms of acute abdominal pain. Pelvic ultrasound revealed a normal looking uterus and ovaries and next to left ovary a imaging compatible with hydrosalpinx. She was discharged 48 hours later after clinical monitoring with oral analgesia and normal blood workup. At 3 weeks, she was readmitted for acute abdominal pain. Leukocytosis with left shift and raised C-reactive protein were observed. Her clinical condition worsened, and complication of the preexisting hydrosalpinx was suspected. Exploratory laparoscopy confirmed torsion of the fallopian tube. Left salpingectomy was performed. Histopathologic study confirmed a fallopian tube with hemorrhagic infarct. Conclusion Torsion of the fallopian tube must be considered in the event of acute abdominal pain. Early diagnosis and trying conservative management with a view to preserving fertility in this group of patients are essential.

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

“…2,25 By analysis of the DAP of 10-case fever patients, 6,17,19,25,29,31,34,36,37 especially for one case which displayed no fever firstly, but fever after 3 weeks. 26 We found the DAP of fever patients showed obvious extension; however, the risk of fever increases significantly with the prolongation of DAP (χ 2 = 15.57, p < 0.001), and this report of Martin-Vallejo also confirmed it. 25 Moreover, the number of adverse outcomes such as fallopian tube necrosis and resection in febrile patients significantly increased ( p < 0.05), but it seems to be unrelated to the number of tubal twists ( p > 0.05), which fully indicates that the treatment of IFTT requires early detection and intervention.…”

“…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.…”

Computed tomography findings of chronic isolated fallopian tube torsion: a case description

“…The clinical and imaging manifestations of tubal torsion are nonspecific, which often leads to clinical misdiagnosis. Although surgery is the gold standard for the diagnosis of AT ( 4 ), imaging features usually form the basis for the initial clinical diagnosis.…”

“…Cases of IFTT without ovarian torsion are usually accompanied by two risk factors, hydrosalpinx and parafallopian mass ( 1 , 2 ). Some studies have suggested that right fallopian tube torsion is more common than left fallopian tube torsion because the left side is thought to be fixed by the sigmoid mesentery ( 4 , 6 ). However, according to a recent review, most cases of tubal torsion occur on the left side (14/20) ( 3 ), which contradicts the previously held view.…”

Giant Isolated Left Hydrosalpinx Simulating Ovarian Cyst in a Sexually Inactive Adolescent Successfully Treated with Laparoscopy

“…MRI is much more useful for making this distinction; however, MRI is not always performed in an emergency. Isolated tubal torsion with hydrosalpinx has been reported in the premenarchal girls [8]. Bertozzi et al [9] reported just 20 cases in 26 years at five pediatric surgery units in a retrospective analysis.…”