Isolated Tubal Torsion: A Rare Cause of Acute Pelvic/Abdominal Pain among Adolescent Females

Mohamad K Ramadan; Khouloud Demachkie; Amani Mohsen; Loubna Sinno; Janoub Kaza'al

doi:10.4103/GMIT.GMIT_91_19

Isolated Tubal Torsion: A Rare Cause of Acute Pelvic/Abdominal Pain among Adolescent Females

Gynecol Minim Invasive Ther. 2020 Aug 12;9(4):241-244. doi: 10.4103/GMIT.GMIT_91_19. eCollection 2020 Oct-Dec.

Authors

Mohamad K Ramadan^{1

2}, Khouloud Demachkie^{1

3}, Amani Mohsen¹, Loubna Sinno⁴, Janoub Kaza'al^{1

2}

Affiliations

¹ Department of Obstetrics and Gynecology, Rafik Hariri University Hospital, Beirut, Lebanon.
² Department of Obstetrics and Gynecology, Lebanese University, Beirut, Lebanon.
³ Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
⁴ Research Unit, Makassed General Hospital, Beirut, Lebanon.

Abstract

Tubal torsion usually occurs as a part of adnexal torsion that affects an ovary and the adjacent tube; however, isolated tubal torsion is an extremely rare condition. Usually, it presents as acute pelvic/abdominal pain but could also exhibit milder intermittent pain alternating with periods of relief (subacute). This condition has seldom been diagnosed preoperative and commonly results in tubal damage due to delayed management. We hereby, report the findings of two cases managed recently at our center. In both cases, the diagnosis was delayed 2-3 days and was only made intraoperative when the tubes could not be salvaged due to extensive necrosis. The extent of tubal damage is predominantly dependent on the duration of vascular insult; hence, the urgency for affecting early diagnosis and intervention to restore blood supply and preserve tubal integrity and function. We advocate the liberal and early use of laparoscopy in patients presenting with subacute unexplained pelvic/abdominal pain.

Keywords: Isolated tubal torsion; laparoscopy; subacute pelvic/abdominal pain.

Publication types

Case Reports