Srpski arhiv za celokupno lekarstvo 2015 Volume 143, Issue 7-8, Pages: 471-475
https://doi.org/10.2298/SARH1508471J
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Isolated fallopian tube torsion: A challenge for the timely diagnosis and treatment
Jokić Radoica (Medical Faculty, Novi Sad + Institute for Children and Adolescents Health Care of Vojvodina, Pediatric Surgery Department, Novi Sad)
Lovrenski Jovan (Medical Faculty, Novi Sad + Institute for Children and Adolescents Health Care of Vojvodina, Radiology Department, Novi Sad)
Lovrenski Aleksandra (Medical Faculty, Pathology Department, Novi Sad)
Trajković Veličko (Institute for Children and Adolescents Health Care of Vojvodina, Pediatric Surgery Department, Novi Sad)
Introduction. Isolated torsion of the fallopian tube is a rare cause of acute
lower abdominal pain and infrequent indication for surgical treatment. Case
Outline. A 16-year-old girl was referred to the hospital due to the
non-specific symptoms over period of a few months and pain acutization in the
right infraumbilical region lasting for two days. Complete laboratory
analyses were normal. Ultrasound examination revealed a round mass (23Ч14 mm)
within the right fallopian tube with color Doppler whirlpool sign, normal
ovary, and a simple ipsilateral paratubal cyst (50x40 mm). Laparoscopy showed
a dilated and two times torquated right fallopian tube, as well as signs of
chronic appendicitis. The tube was twisted about its longitudinal axis and it
was livid, but not gangrenous. After appendectomy, fallopian tube was
detorquated, cyst extracted and preservation of the tube was performed.
Postoperatively, antibiotic therapy was administered based on antibiogram. On
follow-up examinations within the next four months postoperative course was
uneventful. Conclusion. Since there are no pathognomonic symptoms, clinical
or laboratory findings, diagnosis of this condition is challenging.
Familiarity with Doppler whirlpool sign can enable a timely diagnosis and
treatment of isolated fallopian tube torsions. However, the diagnosis is
rarely made before operation. Unlike in our case, surgery is often performed
too late, and delay of intervention may result in failure to save the
fallopian tube.
Keywords: fallopian tube, torsion, ultrasound, laparoscopy