Rare case of torsion of right hysdrosalpinx in adolescent girl aged 16.
Isolated fallopian tube torsion is a rare event, occurring most commonly in the reproductive years and rarely in adolescents. Hydrosalpinx is one of the predisposing factors of adnexal torsion. The incidence of hydrosalpinx in adolescent virgin patients is very rare, thus it may cause diagnostic dilemma, leading sometimes to suboptimal treatment. The exact cause is not known but majority of the cases occur secondary to certain intrinsic and extrinsic tubal factors, which include abnormal length or spiral course of tube, hydrosalpinx, paraovarian cysts, pelvic adhesions, pelvic congestion, and pregnancy.
Case: A 16 year old sexually inactive girl presented with left abdominal pain for two days associated with nausea. The physical examination revealed left lower quadrant tenderness. Abdominal ultrasound showed right tubal enlargement and Doppler study reveal compromised adnexal blood supply indicating adnexal torsion.
She was managed laparoscopically. Torsion of the right fallopian tube on its longitudinal axis was observed in a clockwise direction. The tubal swelling was probably a hydrosalpinx, which became a hematosalpinx as the patient did not seek treatment for 2 days since the onset of symptoms. The tube was untwisted in anti-cloakwise direction and a salpingectomy was performed.
The right ovary was very minimally handled and no compromise of ovarian blood supply was done during the process of salpingectomy. The right ovary and left adnexa was free of any pathology.
The earlier tubal torsion is diagnosed, the greater the likelihood of salvaging the fallopian tube. Laparoscopic management of twisted hydrosalpinx in a 17 year old girl
Laparoscopic management of twisted hydrosalpinx in a 17 year old girl
Twisted hydrosalpinx in young girl. As she presented 48 hours after the onset, hydrosalpinx became a hematosalpinx
Twisted hydrosalpinx in young girl. As she presented 48 hours after the onset, hydrosalpinx became a hematosalpinx
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