Isolated tubal torsion: Successful preoperative diagnosis of five cases using ultrasound and management with laparoscopy

Fadıloğlu, Erdem; Dur, Rıza; Demirdağ, Erhan; Öztürk, Çağatayhan; Fadiloglu, Seyma; Kaplan, Metin; Tapisiz, Omer Lutfi

doi:10.4274/tjod.57984

Cited by 12 publications

(17 citation statements)

References 11 publications

(10 reference statements)

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“…[ 10 ] Color Doppler may be useful in diagnosing the IFTT, but normal flow definitely will not rule out the torsion. A whirlpool sign is known for its high sensitivity in diagnosing the IFTT,[ 9 11 ] which was not assessed in our study; hence, the diagnosis could be missed and none of the patients were identified as adnexal torsion by imaging modality in our series.…”

Section: Discussionmentioning

confidence: 89%

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

et al. 2020

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Isolated Fallopian tube torsion (IFTT) is a rare entity with utmost important gynecological emergency with difficult preoperative diagnosis. Our aim is to analyze the clinical presentation, risk factors, and management of IFTT. We retrospectively analyzed all patients with intraoperative diagnosis of IFTT in our endogynecological department over a time period of 3 years and 6 months (January 2015–June 2018) in a tertiary level laparoscopic center. The clinical profile of the patients was analyzed and the results formulated. Statistical analysis was done by SPSS system, Version 15.00 (SPSS Inc., Chicago). A total 17 cases were diagnosed with IFTT with or without pathology. The mean age was 28.07 ± 11.3 years. Lower abdominal pain was the most common symptom (88%). About 47% had a history of tubal ligation. Salpingectomy was done in the majority of the patients (82.3%). Detorsion and preservation of the tube was possible in 17.6% of the cases. High index of suspicion is needed to diagnose this rare cause of acute abdomen. Hence, an early intervention can enhance the salvageability of the affected tubes which has a positive impact on the fertility status of the patients. Tubal preservation is the preferred procedure of choice whenever feasible.

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Section: Discussionmentioning

confidence: 89%

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

et al. 2020

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“…Although normal vascular flow is observed in the ovaries, a lack of diastolic flow or an observation of diastolic reverse stream together with high-impedance arterial stream in Doppler US of the adnexal mass wall may increase the suspicion of tubal torsion. However, the observation of a normal stream form by Doppler US does not always exclude the torsion [ 1 , 11 , 17 , 18 ]. In our patient’s case, tubal pathology was suspected because of the normal appearance of the ovaries separately and detection of an irregular cystic mass in the adnexal region by US, and tubal torsion was also considered among the preoperative differential diagnoses.…”

Section: Discussionmentioning

confidence: 99%

“…Although imaging methods are generally helpful in patients with acute abdominal pain, fallopian tube torsion is rarely diagnosed preoperatively [ 13 ]. However, Fadıloğlu et al reported that five patients with lower abdominal pain of different severities were diagnosed with preoperative tubal torsion using US alone; no other imaging method other than US was used, and these diagnoses were confirmed by laparoscopy [ 17 ]. In our opinion, especially in women with acute abdominal pain who are of reproductive age, tubal torsion can be seriously suspected by physical examination and US evaluation if considered among the differential diagnoses.…”

Section: Discussionmentioning

confidence: 99%

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

Kartal

Birge

2020

J Med Case Reports

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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.

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“…Given visualisation of this sign will provide a definitive diagnosis of this challenging condition, careful scanning of the adnexa by the sonographer is warranted. It has been suggested that the correct evaluation of the adnexa commences at the interstitial tubal segment and extends towards the fimbria . In this case, the whirlpool sign could not be visualised on retrospective analysis of stored longitudinal and transverse cine loops of the right adnexa, even after reviewing the operative findings.…”

Section: Discussionmentioning

confidence: 99%