Hydrosalpinx with adnexa torsion treated with a salpingostomy in a virgin woman

Abstract

Hydrosalpinx in reproductive-age women without sexual experience is uncommon and may be asymptomatic. Hydrosalpinx-induced torsion of the adnexa is a rare situation and requires prompt and accurate management. This report describes a 21-year-old female without history of sexual intercourse presented with right lower abdominal pain. Ultrasonography revealed right ovary about 4.2 cm × 3.6 cm in size with a well-defined, round cystic mass measuring 6.3 cm × 4.1 cm without septations. Diagnostic laparoscopic surgery showed a darkish right ovary and round-shaped cystic right hydrosalpinx that twisted at the infundibulopelvic ligament. Laparoscopic detorsion and salpingostomy were performed successfully. This case is a rare gynecologic situation with hydrosalpinx induced adnexa torsion, making it a rare presentation. Early diagnosis is important for preventing ovarian gangrene. Laparoscopy is a useful tool for diagnosing and treating tubal and ovarian torsion. It brings good prognosis if detorsion was performed within 24 h.

Keywords

• Adnexa
• hydrosalpinx
• laparoscopy
• torsion
• ultrasonography