Identification of 3 Subtypes of Isolated Fallopian Tube Torsion in 19 Laparoscopically Confirmed Cases: Case Series and Literature Review

Abstract

Objective: This research was conducted to clarify the clinical background, incidence, radiologic characteristics, and surgical and pathologic diagnosis of isolated fallopian-tube torsion (IFTT), with its potential classification into 3 subtypes. Materials and Methods: This retrospective observational study of 19 cases of IFTT was for a 15-year time period. For a comparative study, records for 19 consecutive recent cases of tubo-ovarian torsion were extracted. IFTT cases were classified into 3 subtypes based on laparoscopic findings: Type 1 (organoaxial form), wherein IFTT occurs along the longitudinal axis without a leading mass; Type 2 (organoaxial form), wherein IFTT occurs along the longitudinal axis with a leading mass; and Type 3 (mesenteroaxial form), wherein IFTT occurs around the short axis. Results: Adnexal torsions were confirmed via laparoscopic surgery in 183 cases. Tubo-ovarian torsion and IFTT were diagnosed in 164 (89.6%) and 19 (10.4%) cases, respectively. The median diameter of the masses measured by ultrasonography was shorter in IFTT (6.1 cm) than in tubo-ovarian torsion (10.7 cm). IFTT occurred more frequently on the right side (12 cases) than on the left side (7 cases). Tubal conservation was possible by paratubal cystectomy after detorsion. Types 1, 2, and 3 of IFTT were identified in 2, 16, and 1 cases, respectively. Conclusions: IFTT is a challenge in diagnosis and management; however, IFTT should be recognized as a more-frequently encountered condition. Type 2 IFTT with paratubal cyst is the most-frequent; hydrosalpinx can cause Types 1 and 3 IFTT. (J GYNECOL SURG 20XX:000)