Diagnosis and laparoscopic management of a fallopian tube torsion following Irving tubal sterilization: a case report.

Abstract

Tubal torsion is a very rare but serious clinical entity. Its occurrence has been reported following Pomeroy tubal ligation and laparoscopic tubal cauterization. The following case report will be the first one describing a tubal torsion after an Irving tubal ligation in a patient who also had a history of pelvic inflammatory disease (PID). This study includes the presentation of a case of tubal torsion that is diagnosed and managed laparoscopically and the review of the literature through a computerized search of MEDLINE for relevant cases in the English literature published between January 1966 and July 1999. The patient is a 26-year-old woman with a history of PID and Irving tubal ligation. She presented with a second episode of acute right lower quadrant pain. The patient underwent a diagnostic laparoscopy and was found to have a 6 x 5 cm hemorrhagic and necrotic fallopian tube consistent with torsion of the right tube. A right salipingectomy was done laparoscopically. Combination of PID and tubal sterilization in the medical history of a patient presenting with acute or intermittent pelvic pain may suggest tubal torsion.