Hydrosalpinx with adnexa torsion treated with a salpingostomy in a virgin woman

Abstract

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.

Isolated tubal torsion: A rare cause of acute pelvic/abdominal pain among adolescent females

“…In the majority of cases, torsion occurred in the midsegment of the fallopian tube, but it may, as well, occur around the ligamentous supports of the tube. [ 7 ] If the rotation is partial or intermittent; the venous and lymphatic congestion may subside quickly, along with related symptoms. If twisting is complete and prolonged, venous and arterial thrombosis ensues, eventually resulting in tubal infarction and necrosis.…”

Isolated fallopian tube torsion: A rare twist with a diagnostic challenge that may compromise fertility

“…Concerning salpingectomy in our series, most of the torsions were noted in the distal two-third of the tube, and we believe that the complete salpingectomy is better than partial whenever it is necessary because the proximal nonfunctional part of the tube can be a site of ectopic pregnancy or reformation of hydrosalpinx if it gets occluded and removal of only ampulla and fimbria and keeping the nonfunctional portion is of no use and may increase the risk of recurrence. [ 7 13 ] Hence, we did complete salpingectomy in all our patients [ Figure 1 right Fallopian tube torsion Grade 4 necrotic tube].…”