Bilateral torsion of fallopian tubes with bilateral hydrosalpinx: a case report

Abstract

Background Isolated fallopian tube torsion is a very rare cause of acute abdominal pain in women and, as can be expected, its being bilateral is an extremely rare condition. It is more common in women in reproductive age compared to other age groups. Symptoms, physical examination, imaging and laboratory findings being nonspecific makes it difficult to establish the correct diagnosis and often the diagnosis can be made during surgery. Despite being a very rare condition in general, it is important in terms of preservation of tube and thus the fertility especially in women of reproductive age with early diagnosis and treatment. Therefore, keeping in mind the fallopian tube torsion among the differential diagnoses in women presenting with acute abdominal pain will contribute to early diagnosis and treatment. Case presentation A 38-year-old white Arabian woman, gravida 1, parity 0, abort 1, sought medical advice in our outpatient clinic with a complaint of lower abdominal pain that had started 2 days earlier. The pain had first started as mild cramps, which then suddenly intensified nearly 2 hours before her presentation to our clinic, spread to the groin and femur, more prominent on the right side, and became an ongoing pain. As preoperative diagnoses of the patient, ovarian cyst rupture and ectopic pregnancy were suspected, and fallopian tube torsion was also suspected due to the normal appearance of the ovaries and the appearance of the hydrosalpinx on ultrasonography. The patient underwent laparotomy with a Pfannenstiel incision. Both tubes had hydrosalpinx, and the fimbrial ends were blunt and obliterated. Bilateral salpingectomy was performed because the right tube had a prominent necrotic appearance, and there was a significant hydrosalpinx in both tubes. Conclusion Bilateral fallopian tube torsion should be considered among the differential diagnoses in women presenting with acute pelvic pain.

Appendicular-genital syndrome in children

“…У процесі виконання діагностичної лапароскопії є змога провести оцінку: топографії внутрішніх органів, стану тонкої та товстої кишки; наявність гриж і вад розвитку органів черевної порожнини; наявність і ступінь запалення стінки апендикса; зовнішнього вигляду маткових труб; наявність, характер і можливе джерело патологічного ексудату; тонус/ ригідність стінок маткових труб; наявність/відсутперитубарних злук тощо [13,19]. На блок-схемі наведено алгоритм діагностики який дає змогу підвищити якість диференційної діагностики синдрому «гострого живота», зменкількість досліджень, знизити навантаження на пацієнтку і скоротити термін перебування в стаціонарі, що є позитивною тенденцією як для дитини, так і для медичного закладу (рис.…”