Isolated Fallopian Tubal Torsion Complicated by a Large Hydrosalpinx in a Perimenopausal Woman

Abstract

Adnexal torsion frequently causes acute pelvic pain in women. Ovarian tumour torsion is common; twisting and torsion of a fallopian tube are rare. This report presents a rare case of fallopian tubal torsion requiring the management of a large hydrosalpinx with laparoscopic surgery. A 48-year-old woman reported with acute abdominal pain and lower abdomen tenderness. Transvaginal ultrasonography and Magnetic Resonance Imaging (MRI) showed a cystic mass on the anterior uterine surface. Emergency surgery was performed for a suspected torsion of the left ovarian cyst. In the abdominal cavity, the left fallopian tube was enlarged (neonatal head size), dark purple coloured, and exhibited a 180° torsion; the left ovary was normal. Laparoscopic left salpingectomy was performed and the postoperative course was uneventful. Surgical pathology revealed hydrosalpinx with torsion. As diagnosing isolated fallopian tube torsion before surgery is difficult, laparoscopic surgery is useful in diagnosing and treating isolated tubal torsion.

Keywords

• acute abdomen
• adnexal torsion
• laparoscopic surgery