Isolated tubal torsion associated with hydrosalpinx

Esra Tamburaci

doi:10.31083/j.ceog4901005

Abstract

Background: Isolated tubal torsion associated with hydrosalpinx is a rare pathology. Our aim was to analyze clinical and imaging features. Case: A 15-year-old girl was admitted to the gynecological emergency department with lower abdominal pain. She was virgin and did not have gynecological examination. In ultrasonography a 10 cm cystic lumen was observed in the right tube. Right salpingectomy was performed. In the pathological examination, there was ischemic changes due to torsion. Conclusion: Isolated tubal torsion is extremely rare in early adolescent period. Early surgical intervention after diagnosis is important for fertility.

Highlights

Isolated tubal torsion associated with hydrosalpinx (ITTH) is a very rare cause of acute abdomen with a frequency of 1/1.5 million [1]
The cause of isolated tubal torsion is not known exactly, we can list the possible etiologies in paediatric patients as follows: physiological abnormalities such as long meso-salpingx, hydro/hematosalpinx, tubal and adnexal mass, anatomical abnormalities, abnormal peristalsis or periovulatory spasm, hemodynamic abnormalities such as venous congestion, Sellheim’s theory, which indicates sudden body position changes, trauma
Since the left tube is close to the sigmoid mesentery, its mobility is less than the right tube

Summary

Introduction

Isolated tubal torsion associated with hydrosalpinx (ITTH) is a very rare cause of acute abdomen with a frequency of 1/1.5 million [1]. The underlying mechanism is not fully understood, it can be classified as intrinsic and extrinsic factors. Intrinsic factors are tube-related causes such as congenital anomalies, neoplasm, and hypermobility of the tube, and extrinsic factors are ovarian para tubal masses, pregnancy or tumor-induced uterine growth, pelvic inflammatory disease, adhesions and pelvic organ trauma [2]. The diagnosis is usually made during surgical exploration. Since early diagnosis is important for the protection of the tube, this rare situation should be considered in young patients presenting with an acute abdomen

Case presentation

Discussion

Conclusions