Isolated Torsion of the Fallopian Tube During Pregnancy

Abstract

EDITORIAL COMMENT: We accepted this case for publication because it will remind readers of an unusual cause of right-sided abdominal pain during pregnancy. The case particularly appealed to the Editor who had in the previous few weeks seen 3 women with quite severe round ligament strain. Round ligament strain can usually be diagnosed over the telephone by asking the patient to feel the tender area lateral to the uterus on one or other side although occasionally it is bilateral. This common condition receives scant attention in textbooks yet often causes women considerable distress in the middle of the second trimester. Presumably later in pregnancy the changes in the ligament are accommodated because the patient no longer experiences localized spasm and tenderness. In one of the cases referred to above the pain was sufficient to raise the possibility of appendicitis and the fact that the nearby uterus was tender also raised the possibility of placental abruption and an ultrasound was performed for this reason. In the present case although the tube was gangrenous one wonders whether laparotomy would have been performed had the ultrasound scan been negative!