Diagnostic laparoscopy in isolated torison of hydrosalpinx: a likely cure for an unlikely disorder

Abstract

Isolated torsion of fallopian tubes is a rare cause of acute abdomen. It is a diagnosis that is often reached after much delay. This is primarily because it has no pathognomonic clinical, radiological or laboratory signs. In such cases, it is advisable to have a low threshold for diagnostic laparoscopy. We managed a middle-aged lady with acute abdomen and after initial tests were inconclusive, we proceeded to diagnostic laparoscopy without much delay and found a twisted right hydrosalpinx. We performed a right salpingectomy as her family was complete. The fallopian tube and ovary usually act as a unit and an isolated torsion of the fallopian tube is a rare occurrence with few tell-tale sign. After cross sectional imaging, we can be fairly certain of an adnexal pathology. A delay in making a diagnosis can lead to catastrophic consequences in such conditions. An early laparoscopy can be both diagnostic and therapeutic in these cases.