Torsion of the Fallopian Tube: Two Contrasting Presentations and Review of the Literature

Abstract

Abstract

Background: Isolated Fallopian tubal torsion is an extremely rare event, which primarily affects women in the reproductive age group. Such patients are frequently referred for sonography to evaluate the adnexa, in particular for the identification of ovarian torsion that demands early surgical intervention. Cases: Two cases with dissimilar presentations of tubal torsion are described. The first patient underwent laparoscopy for an incidentally detected live tubal ectopic pregnancy and was found to have concomitant tubal torsion intraoperatively. The second patient presented with acute abdomen in the 21st week of pregnancy, was surgically explored with a suspicion of appendicitis, and detected to have a twisted gangrenous Fallopian tube at laparotomy. Salpingectomy was performed in both cases. Results: Both patients recovered uneventfully. The first patient was subsequently lost to follow-up. The second patient had a cesarean delivery in the 41st week of gestation and is 7 weeks pregnant at the time of writing this article. Conclusions: The diagnosis is difficult because of lack of specific findings. Awareness and recognition of this condition and prompt intervention increase the likelihood of tubal-sparing surgery and preservation of fertility. (J GYNECOL SURG 30:28)