Background: Isolated torsion of the fallopian tube is a rare occurrence, which generally presents in the reproductive age group. It is difficult to diagnose on imaging, and diagnosis is established after surgery. Case: This report describes an unusual presentation of an uncommon condition in a perimenopausal 48-year-old woman who presented with acute abdomen. The clinical and imaging features led to suspicion of ovarian cyst with appendicitis. Laparotomy revealed torsion of hematosalpinx, with both the ovaries being normal. Results: The postoperative period was uneventful, and the patient was discharged on the 5th postoperative day. Histopathology report showed hemorrhagic infarction of tubular structures. Conclusions: Torsion of the fallopian tube is a rare event in the perimenopausal age group. It should, however, be included in the differential diagnosis of acute abdomen, and recognition of imaging features may allow early surgical intervention. (J GYNCOL SURG 28:31)
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