Hydrosalpinx in reproductive-age women without sexual experience is uncommon and may be asymptomatic. Hydrosalpinx-induced torsion of the adnexa is a rare situation and requires prompt and accurate management. This report describes a 21-year-old female without history of sexual intercourse presented with right lower abdominal pain. Ultrasonography revealed right ovary about 4.2 cm × 3.6 cm in size with a well-defined, round cystic mass measuring 6.3 cm × 4.1 cm without septations. Diagnostic laparoscopic surgery showed a darkish right ovary and round-shaped cystic right hydrosalpinx that twisted at the infundibulopelvic ligament. Laparoscopic detorsion and salpingostomy were performed successfully. This case is a rare gynecologic situation with hydrosalpinx induced adnexa torsion, making it a rare presentation. Early diagnosis is important for preventing ovarian gangrene. Laparoscopy is a useful tool for diagnosing and treating tubal and ovarian torsion. It brings good prognosis if detorsion was performed within 24 h.

BACKGROUND Thrombocytopenia with thrombosis syndrome has been reported after vaccination against severe acute respiratory syndrome coronavirus 2 with two mRNA vaccines. The syndrome is characterized by thrombosis, especially cerebral venous sinus thrombosis, and may lead to stroke. Pregnant women with stroke show higher rates of pregnancy loss and experience serious pregnancy complications. We present the case of a 24-year-old pregnant woman with a transient ischemic attack (TIA) that developed after vaccination with the Moderna mRNA-1273 vaccine (at 37 2/7 wk). CASE SUMMARY TIA occurred 13 d following the coronavirus disease vaccination. At 39 1/7 wk of pregnancy, the patient presented with sudden onset of right eye blurred vision with headache, dizziness with nausea, right-hand weakness, anomia, and alexia. The symptoms lasted 3 h; TIA was diagnosed. Blood test results revealed elevated D-dimer, cholesterol, and triglyceride levels. Brain magnetic resonance imaging showed no acute hemorrhagic or ischemic stroke. At pregnancy 37 6/7 wk, she was admitted for cesarean delivery to reduce subsequent risk of stroke during labor. Body mass index on admission was 19.8 kg/m 2 . Magnetic resonance angiography and transesophageal echocardiography showed no abnormalities. The next day, a mature female baby weighing 2895 g and measuring 50 cm was delivered. Apgar scores were 8 and 9 in the first and fifth minutes. D-dimer levels decreased on postoperative day 4. After discharge, the autoimmune panel was within normal limits, including antinuclear and antiphospholipid antibodies. CONCLUSION TIA might be developed after the mRNA vaccines in pregnant women.

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