Laparoscopic management of ischemic right fallopian tube torsion mimicking perforated appendicitis

Int J Surg Case Rep. 2022 Apr:93:106914. doi: 10.1016/j.ijscr.2022.106914. Epub 2022 Mar 1.

Abstract

Background: Isolated fallopian tube torsion is a rare cause of acute lower abdominal pain in females. A history of hemosalpinx, hydrosalpinx, or ovarian or paraovarian cysts might all be risk factors. Diagnosis is frequently delayed until it's too late to salvage the tube.

Case presentation: A 32-year-old lady with no prior medical and surgical history presented to our emergency department with a four days history of severe right lower abdomen pain and tenderness accompanied by nausea. Clinically, she was feverish, with elevated C reactive protein levels, negative serum Beta HCG, and normal urine analysis. Computed tomography demonstrated a 5x3cm collection in the right lower quadrant of the abdomen. A diagnostic laparoscopy was performed upon exploration a Twice-fold twisted ischemic right fallopian tube with hydrosalpinx was found and Salpingectomy was performed.

Conclusions: Torsion of the fallopian tube is an uncommon cause of acute lower abdominal pain in women. The exact process that causes isolated tubal torsion is unknown. Early diagnostic laparoscopy and surgical intervention are essential in a nulliparous young woman.

Keywords: Diagnostic laparoscopy; Fallopian tube; Hydrosalpinx; Torsion.