Isolated fallopian tube torsion associated with hydrosalpinx in a 12-year-old girl: a case report

Javier Martín-Vallejo,Enrique E Garrigós-Llabata,Patricia Molina-Bellido,Pedro A Clemente-Pérez

doi:10.1186/s13256-020-02462-1

Abstract

BackgroundIsolated fallopian tube torsion associated with hydrosalpinx is a rare condition in the pediatric population. We present this unusual clinical case study in a sexually inactive girl.Case presentationa12-year-old Caucasian girl presented symptoms of acute abdominal pain. Pelvic ultrasound revealed a normal looking uterus and ovaries and next to left ovary a imaging compatible with hydrosalpinx. She was discharged 48 hours later after clinical monitoring with oral analgesia and normal blood workup. At 3 weeks, she was readmitted for acute abdominal pain. Leukocytosis with left shift and raised C-reactive protein were observed. Her clinical condition worsened, and complication of the preexisting hydrosalpinx was suspected. Exploratory laparoscopy confirmed torsion of the fallopian tube. Left salpingectomy was performed. Histopathologic study confirmed a fallopian tube with hemorrhagic infarct.ConclusionTorsion of the fallopian tube must be considered in the event of acute abdominal pain. Early diagnosis and trying conservative management with a view to preserving fertility in this group of patients are essential.

Highlights

Several intrinsic or extrinsic predisposing factors have been identified in adults as being associated with isolated fallopian tube torsion (IFTT) [1]
Hydrosalpinx can occur free of symptoms; when associated with IFTT, it is usually accompanied by symptoms of nonspecific abdominal pain [2]
We observed normal development of secondary sexual characteristics in Tanner stage 3–4. She presented with abdominal pain on deep palpation in the left iliac fossa, was free of signs of peritoneal irritation, Martín-Vallejo et al Journal of Medical Case Reports (2020) 14:165 and had no organ masses or organomegaly

Summary

Introduction

Several intrinsic or extrinsic predisposing factors have been identified in adults as being associated with isolated fallopian tube torsion (IFTT) [1]. Hydrosalpinx can occur free of symptoms; when associated with IFTT, it is usually accompanied by symptoms of nonspecific abdominal pain [2]. She reported abdominal pain of 48-hour clinical course located in the left iliac fossa as well as feeling nauseous. She presented with abdominal pain on deep palpation in the left iliac fossa, was free of signs of peritoneal irritation, Martín-Vallejo et al Journal of Medical Case Reports (2020) 14:165 and had no organ masses or organomegaly.

Results

Conclusion