Abstract
Adnexal torsion is responsible for 2.7% of all gynecological emergencies. Ectopic pregnancy is relatively common, occurring in 2% of all pregnancies. We report the second case of ruptured right tubal ectopic gestation with torsion of serous cystadenoma of left ovary. This was diagnosed after emergency laparoscopy done for acute abdomen. Right salpingectomy and left ovarian detorsion followed by cystectomy were done laparoscopically.
Highlights
Both ectopic pregnancy and adnexal torsion represent surgical emergencies
We hereby report the second case of ruptured ectopic pregnancy with coexisting contralateral ovarian torsion due to serous cystadenoma
Traditional management of salpingo-oophorectomy in adnexal torsion can destroy the future fertility in cases where the contralateral adexum is diseased
Summary
Both ectopic pregnancy and adnexal torsion represent surgical emergencies. We hereby report the second case of ruptured ectopic pregnancy with coexisting contralateral ovarian torsion due to serous cystadenoma. Traditional management of salpingo-oophorectomy in adnexal torsion can destroy the future fertility in cases where the contralateral adexum is diseased. The association between detorsion and systemic thrombosis is not certain. The management of this surgical emergency can be either laparotomy or laparoscopy. Since the patient was hemodynamically stable, we proceeded with diagnostic laparoscopy under general anesthesia which revealed (1) right ruptured tubal ectopic pregnancy, (2) left ovarian cyst torsion, (3) normal right ovary, left tube, and uterine contour, and (4) haemoperitoneum of 50 cc. Histopathology revealed chorionic villi in right tube and serous cystadenoma of left ovary
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