Isolated fallopian tube torsion is very rare which is reported to be 1 in 1.5 million women. Fallopian tube torsion is commonly associated with hydrosalpinx, hematosalpinx or paratubal cysts such as hydatids of Morgagni. Fallopian tube torsion generally presents a diagnostic dilemma because symptoms and signs mimics ovarian torsion such as acute lower abdominal pain, vomiting, tenderness on palpation but ultrasound may show normal ipsilateral ovary. Right sided adnexal torsion may be difficult to differentiate from acute appendicitis clinically. In such cases ultrasound is helpful but diagnostic laparoscopy is gold standard. We encountered a rare case of torsion hematosalpinx concurrent with acute appendicitis. Patient was presented with acute onset severe lower abdominal pain associated with vomiting and tenderness in right iliac fossa. It was diagnosed as acute tip appendicitis and right adnexal cystic mass either hydrosalpinx/hematosalpinx in ultrasonography. Laparoscopy was done and it was found to be right sided torsion hematosalpinx along with inflamed tip of appendix. Right sided salpingectomy and appendicectomy was done laparoscopically. Fallopian tube torsion should be suspected and diagnostic laparoscopy should be considered in cases of acute onset lower abdominal pain in which ovarian pathology was not found in ultrasonography, that helps in earlier intervention and even in early cases fallopian tube can be salvaged.
Diagnostic laparoscopy has been performed ever since inter ests in infertility and fertility have developed. Methylene blue is administered to check tubal patency during the procedure. Extravasation of methylene blue is a recognized complication of diagnostic laparoscopy and chromopertubation. Anaphy laxis and anaphylactic reactions in the perioperative period are a significant concern for surgeons and anesthesiologists. The incidence is as high as 1 in 3,500 with a mortality rate of 3 to 6%. 16 There are no relevant literature or research article that provides sufficient data or guidelines for determining the nature of these reactions, mode of treatment algorithm, or the certain specifications we should consider before performing the procedure. This is a review literature for performing a safe practice evaluation and management.
Diagnostic laparoscopy has been performed ever since inter ests in infertility and fertility have developed. Methylene blue is administered to check tubal patency during the procedure. Extravasation of methylene blue is a recognized complication of diagnostic laparoscopy and chromopertubation. Anaphy laxis and anaphylactic reactions in the perioperative period are a significant concern for surgeons and anesthesiologists. The incidence is as high as 1 in 3,500 with a mortality rate of 3 to 6%.16 There are no relevant literature or research article that provides sufficient data or guidelines for determining the nature of these reactions, mode of treatment algorithm, or the certain specifications we should consider before performing the procedure. This is a review literature for performing a safe practice evaluation and management.
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