scholarly journals Isolated Fallopian Tube Torsion

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
S. Kardakis ◽  
A. Barranca ◽  
A. Vitelli ◽  
I. Amore ◽  
F. Trento ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Fallopian Tube ◽  
Pelvic Pain ◽  
Lower Abdominal Pain ◽  
Laboratory Findings ◽  
Clinical Imaging ◽  
Adnexal Masses ◽  
Preoperative Ultrasound ◽  
Cystic Component ◽  
Acute Pelvic Pain

Isolated torsion of the Fallopian tube is a rare gynecological cause of acute lower abdominal pain, and diagnosis is difficult. There are no pathognomonic symptoms; clinical, imaging, or laboratory findings. A preoperative ultrasound showing tubular adnexal masses of heterogeneous echogenicity with cystic component is often present. Diagnosis can rarely be made before operation, and laparoscopy is necessary to establish the diagnosis. Unfortunately, surgery often is performed too late for tube conservation. Isolated Fallopian tube torsion should be suspected in case of acute pelvic pain, and prompt intervention is necessary.

CLINCIAL PRESENTATION AND ULTRASONOGRAPHIC MARKERS OF PID

2021 ◽  
pp. 43-47
Author(s):  
Uma Jain ◽  
Deepali Jain ◽  
Urvi Gupta
Keyword(s):  
Abdominal Pain ◽  
Clinical Examination ◽  
Female Genital Tract ◽  
Lower Abdominal Pain ◽  
Abnormal Uterine Bleeding ◽  
Pelvic Examination ◽  
Acute Pelvic Pain ◽  
Number Of Patients ◽  
Pouch Of Douglas ◽  
Cervical Motion

INTRODUCTION: Pelvic inammatory disease (PID) comprises a spectrum of inammatory disorders of the upper female genital tract, including any combination of endometritis, salpingitis, Tubo-ovarian abscess, and pelvic peritonitis. The CDC has estimated that more than I Million women experience an episode of PID every year. Studies have reported prevalence ranging from 5.2% to 17.2% PID in various parts of India. Ultrasound:- TAS was initially used followed by use of TVS with Doppler in diagnosis of PID, although there are no large studies evaluating its sensitivity and or overall usefulness. Itis a frequentlyordered study in patients with classic symptoms of PID or who have unexplained, acute pelvic pain. MATERIAL AND METHODS:A retrospective analysis of medical records of patients with a complaint of lower abdominal pain was included in the study. Diagnosis of PID was made and patient was followed in the outdoor clinic. Pelvic examination was made. USG was done. According to symptoms and clinical examination for PID patients, the data was recorded. Medical record of 120 patients from 1 January 2020 to 31 May 2021 from a private clinic in Dist. Shivpuri were studied. RESULTS: In our study out of 120 cases, most of the patients 50.83% belonged to 26-30 years of age, a maximum number of patients were rural 83.33%. Most of the patients were educated below HSC 56.66%. Most of them 85% were married and most of them were multipara 56.66%. The most common presenting complaint was a pain in the abdomen (100%), followed by per vaginal discharge (65%), pain in the lower back (43.33%), abnormal uterine bleeding (40%), dysmenorrhoea (31.66%), dyspareunia (24.16), fever (17.5%) and others. On clinical examination abnormal PV discharge was present in 61.66% of cases, xed and retroverted uterus with or without thickend appendages were found in 55% of cases. Cervical motion tenderness was found in 78.33% of cases. Adnexal tenderness was found in 80% of cases but adnexal mass was found in 10.83% of cases. The most common nding on ultrasound scan was uid in the pouch of douglas 48.33%, followed by distal hydrosalphinx 28.33%, endometritis 18.33%, pyosalpinx 15%, TO Mass 13.33% and Pelvic collection in 10.83% of cases. CONCLUSION:The focus of this study was to identied socio-demographic characteristics of PID, to see the variety of presenting complaints and pelvic examination ndings and to correlate the clinical ndings with the USG ndings of PID. Much studies about the sensitivity & specicity of USG are not available, but this is denitely the most frequently ordered investigation in cases of PID. Transabdominal ndings of 'incomplete septa' 'cog wheel' 'beads on a strings' signs helps in distinguishing a dilated fallopian tube from other cystic adnexal masses To prevent long term sequelae PID should be the part of differential diagnosis in all patients aged 15-44 year with non specic abdominal pain.

scholarly journals Heterotopic pregnancy: a case report

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Tamer Ali ◽  
Mohamed A. Tawab ◽  
Mona Abdel Ghaffar ElHariri ◽  
Alaa A. Ayad
Keyword(s):  
Abdominal Pain ◽  
Adnexal Mass ◽  
Stable Condition ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
First Trimester ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Laboratory Findings ◽  
The Right

Abstract Background Heterotopic pregnancy describes the occurrence of two pregnancies in different implantation sites simultaneously, which is rare, yet it is a challenge to diagnose such a problem due to complex clinical and laboratory findings. In the current study, we present a case of first trimester heterotopic pregnancy diagnosed by ultrasound (US) and magnetic resonance imaging (MRI) and was managed successfully. Case presentation A 22-year-old primigravida lady with spontaneous pregnancy was presented by increasing lower abdominal pain for 5 days with brownish vaginal discharge, nausea, and vomiting episodes. Trans-abdominal and endovaginal ultrasound was performed and revealed a viable intrauterine pregnancy of 8 weeks and 1 day, associated with a heterogeneous complex right adnexal mass. MR imaging revealed a right adnexal mass intimately anterior to the normal right ovary. Laparascopy was done; it revealed a distended right fallopian tube with pregnancy while the right ovary was not seen (impeded in the pouch of Douglas), and right salpingectomy was done. The specimen was sent for histopathology. The patient tolerated the procedure well and was then taken to the recovery room in stable condition. The histopathological report confirmed the diagnosis of ectopic pregnancy. Conclusion However, heterotopic is a rare condition, any pregnant woman presenting with alarming abdominal pain and adnexal abnormality; heterotopic pregnancy should be among the differential diagnosis possibilities. The patient should be thoroughly investigated using ultrasound and MRI if needed, to exclude this rare diagnosis and allow on-time proper management.

scholarly journals Isolated twisted hematosalphinx misleading with ovarian cyst torsion

2019 ◽  
Vol 8 (3) ◽  
pp. 1219
Author(s):  
Vaibhav Khairnar ◽  
Shalini Mahana Valecha ◽  
Pandeeswari .
Keyword(s):  
Acute Abdomen ◽  
Fallopian Tube ◽  
Ovarian Cyst ◽  
Rare Case ◽  
Delayed Diagnosis ◽  
Lower Abdominal Pain ◽  
Clinical Findings ◽  
Reproductive Age ◽  
High Risk Factors ◽  
Acute Pelvic Pain

Normal or chronically inflamed fallopian tube can undergo torsion and present as acute abdomen, simulating clinically as ectopic gestation. Torsion of the fallopian tube is less frequent but significant cause of lower abdominal pain in reproductive age women that is difficult to recognize preoperatively. Authors present a rare case of hematosalpinx with torsion at its pedicle with hemoperitonium who presented as 28 years old female with acute abdomen that was successfully treated. In cases presenting with hemoperitoneum diagnosis of ruptured ectopic pregnancy should be made unless proved otherwise during reproductive age. Rarely ruptured ovarian cyst may also be a cause. Unfortunately, hematosalpinx sometimes can undergo torsion due to circulatory imbalance and can present as hemoperitoneum and circulatory collapse due to rupture. There have been no specific symptoms, clinical findings, imaging or laboratory characteristics identified for this condition. Imaging findings are non-specific in the preoperative diagnosis of torsed fallopian tubes. Therefore, most of cases with isolated fallopian tubal torsion had a delayed diagnosis and a subsequent delay of timely intervention that may result in failure to save tubal function. Torsion of tube can lead to hematosalpinx, hemoperitonium and necrosis of tube which necessitates urgent surgical management. This case report describes a twisted hematosalpinx presentation without any predisposing high-risk factors. A tubal torsion should be suspected in females with acute pelvic pain, of any age group. An early diagnosis and treatment are required to prevent complications. This rare case may highlight a new insight into pathogenesis of tubal torsion associated with hematosalpinx.

Imaging of acute pelvic pain

2021 ◽  
pp. 20210281
Author(s):  
Marijana Basta Nikolic ◽  
Aleksandar Spasic ◽  
Darka Hadnadjev Simonji ◽  
Sanja Stojanović ◽  
Olivera Nikolic ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Clinical Presentation ◽  
Imaging Modality ◽  
Wide Spectrum ◽  
Imaging Features ◽  
Laboratory Findings ◽  
Medical Evaluation ◽  
Acute Pelvic Pain ◽  
Precise Diagnosis ◽  
Line Imaging

Acute pelvic pain (APP) requires urgent medical evaluation and treatment. Differential diagnosis of APP is broad, including a variety of gynecologic and non-gynecologic/ urinary, gastrointestinal, vascular and other entities. Close anatomical and physiological relations of pelvic structures, together with similar clinical presentation of different disorders and overlapping of symptoms, especially in the emergency background, make the proper diagnosis of APP challenging. Imaging plays a crucial role in the fast and precise diagnosis of APP. Ultrasonography is the first-line imaging modality, often accompanied by CT, while MRI is utilized in specific cases, using short, tailored protocols. Recognizing the cause of APP in females is a challenging task, due to the wide spectrum of possible origin and overlap of their imaging features. Therefore, the radiologist has to be familiar with the possible causes of APP, and, relying on clinical presentation, together with laboratory findings, choose the best imaging strategy in order to establish a fast and accurate diagnosis.

scholarly journals Fallopian Tube Torsion as a Cause of Acute Pelvic Pain in Adolescent Females

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Claudia Mueller ◽  
Sandra Tomita
Keyword(s):  
Fallopian Tube ◽  
Pelvic Pain ◽  
Surgical Intervention ◽  
Clinical Signs ◽  
Operative Management ◽  
Adolescent Females ◽  
Diagnostic Dilemma ◽  
Acute Pelvic Pain ◽  
Future Fertility

Purpose. Torsion of the fallopian tube, involving hydatids of Morgagni, though a rare cause of acute pelvic pain in young girls, can pose significant risks to future fertility. Tubal torsion may present as a diagnostic dilemma since the ovary itself usually appears normal on ultrasound. Thus, surgical intervention may be delayed which can lead to worsening necrosis and result in the need for resection of the affected tube.Methods. We reviewed two cases of fallopian tube torsion associated with hydatids of Morgagni in adolescent females.Results. The patients were premenarchal in both cases, aged 10 and 13 years. Both presented with acute clinical signs of ovarian torsion but ultrasound showed the ovary itself to be normal with an adjacent cystic structure. In both cases, the fallopian tube was detorsioned laparoscopically and preserved. The associated cyst was excised in one case and marsupialized in the other.Conclusions. We propose that prompt recognition and operative management of this relatively uncommon source of pelvic pain may prevent unnecessary tubal resection and improve long-term fertility in this population.

scholarly journals Isolated fallopian tube torsion: A challenge for the timely diagnosis and treatment

2015 ◽  
Vol 143 (7-8) ◽  
pp. 471-475 ◽  
Author(s):  
Radoica Jokic ◽  
Jovan Lovrenski ◽  
Aleksandra Lovrenski ◽  
Velicko Trajkovic
Keyword(s):  
Fallopian Tube ◽  
Color Doppler ◽  
Lower Abdominal Pain ◽  
Longitudinal Axis ◽  
Diagnosis And Treatment ◽  
Laboratory Findings ◽  
Chronic Appendicitis ◽  
Timely Diagnosis ◽  
Whirlpool Sign ◽  
The Right

Introduction. Isolated torsion of the fallopian tube is a rare cause of acute lower abdominal pain and infrequent indication for surgical treatment. Case Outline. A 16-year-old girl was referred to the hospital due to the non-specific symptoms over period of a few months and pain acutization in the right infraumbilical region lasting for two days. Complete laboratory analyses were normal. Ultrasound examination revealed a round mass (23?14 mm) within the right fallopian tube with color Doppler whirlpool sign, normal ovary, and a simple ipsilateral paratubal cyst (50x40 mm). Laparoscopy showed a dilated and two times torquated right fallopian tube, as well as signs of chronic appendicitis. The tube was twisted about its longitudinal axis and it was livid, but not gangrenous. After appendectomy, fallopian tube was detorquated, cyst extracted and preservation of the tube was performed. Postoperatively, antibiotic therapy was administered based on antibiogram. On follow-up examinations within the next four months postoperative course was uneventful. Conclusion. Since there are no pathognomonic symptoms, clinical or laboratory findings, diagnosis of this condition is challenging. Familiarity with Doppler whirlpool sign can enable a timely diagnosis and treatment of isolated fallopian tube torsions. However, the diagnosis is rarely made before operation. Unlike in our case, surgery is often performed too late, and delay of intervention may result in failure to save the fallopian tube.

scholarly journals Isolated fallopian tube torsion in an adolescent: a diagnostic challenge

2020 ◽  
Vol 10 (1) ◽  
pp. 340
Author(s):  
Leonor Bivar ◽  
Ana Castro ◽  
Neusa Teixeira
Keyword(s):  
Abdominal Pain ◽  
Fallopian Tube ◽  
Transvaginal Ultrasound ◽  
Rare Event ◽  
Lower Abdominal Pain ◽  
Cystic Mass ◽  
Diagnostic Challenge ◽  
Ovarian Involvement ◽  
Delayed Intervention

Torsion of the fallopian tube without ovarian involvement is an extremely rare event and often difficult to diagnose, but noteworthy, cause of lower abdominal pain. The authors describe a case related to a 14- year-old adolescent with acute lower abdominal pain and vomiting presented to the gynaecological emergency department. Blood tests exhibited modest biochemical parameters of inflammation and a transvaginal ultrasound showed a left adnexal tubular cystic mass with normal ovarian appearance. A diagnostic laparoscopy revealed an isolated fallopian tube torsion. The tube was able to be untwisted with restoration of pelvic anatomy and the follow-up was uneventful. The authors describe a challenging diagnosis in an adolescent in which delayed intervention could compromise her reproductive future. Tubal torsion should however be kept in mind in the differential diagnosis of lower abdominal pain in women of all ages.

scholarly journals Isolated fallopian tube torsion with paraovarian cysts: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liang Qian ◽  
Xue Wang ◽  
Dingheng Li ◽  
Songyi Li ◽  
Jiashan Ding
Keyword(s):  
Abdominal Pain ◽  
Literature Review ◽  
Fallopian Tube ◽  
Lower Abdominal Pain ◽  
Histopathological Diagnosis ◽  
Common Procedure ◽  
Delay In Diagnosis ◽  
Paraovarian Cyst ◽  
History Of ◽  
The Right

Abstract Background Isolated fallopian tube torsion (IFTT) is a rare cause of gynecological acute abdomen, is easily misdiagnosed and often has a delay in diagnosis. IFTT with paraovarian cysts is most frequently reported in studies. Here, we reported a patient diagnosed with IFTT associated with a paraovarian cyst, and we conducted a literature review for IFTT, aiming to identify valuable information that will be helpful for diagnosis and treatment for fallopian tube torsions. Case presentation A 13-year-old girl presented with a 10-day history of right lower abdominal pain that worsened 2 days before presentation. On presentation, ultrasound showed a 5.8 * 5.5 cm hypoechoic cyst adjacent to the right ovary, and between the cyst and ovary, a tortuous thickened tube was visualized. Laparoscopy revealed a triple torsion of the right fallopian tube with a 6-cm paraovarian cyst, and tubal conservation surgery was performed. The postoperative course was uneventful. Histopathological diagnosis revealed serous papillary cystadenoma. Conclusion Paraovarian cystic dilatation often occurs in adolescence and can induce fallopian torsion when the size of the cyst reaches 5-cm. In our review, the median age of patients diagnosed with IFTT with paraovarian cysts was 15 years old, and the main clinical manifestation was emergency abdominal pain. The associated symptoms were variable, and vomiting was the most commonly associated symptom. Salpingectomy was the most common procedure performed; however, timely surgical intervention can effectively avoid salpingectomy.

scholarly journals Ovarian lesions and tumors in infants and older children

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Henning C. Fiegel ◽  
Stefan Gfroerer ◽  
Till-Martin Theilen ◽  
Florian Friedmacher ◽  
Udo Rolle
Keyword(s):  
Abdominal Pain ◽  
Ovarian Tissue ◽  
Germ Cell Tumors ◽  
Lower Abdominal Pain ◽  
Ovarian Tumors ◽  
Ovarian Torsion ◽  
Ovarian Cysts ◽  
Older Children ◽  
Imaging Evaluation ◽  
Laboratory Findings

Abstract Objectives Ovarian lesions are rare but frequent in children. Patients could present with abdominal pain, but ovarian lesions could also be incidentally found on ultrasound. Awareness is required in cases with acute, severe lower abdominal pain, as ovarian torsion could be the cause. Other lesions can be cysts or benign or malignant ovarian tumors. Thus, the aim of this paper is to review typical ovarian lesions according to age, imaging and laboratory findings, and surgical management. Methods We retrospectively analysed the patient charts of 39 patients aged 10.4 ± 6.1 years (from 3 months to 18 years) with ovarian lesions treated in our institution between 01/2009 and 08/2020. All clinical and pathological findings of infants and children operated on for ovarian lesions were included. Results Ovarian lesions in children younger than 2 years of age were typically ovarian cysts, and ovarian tumors were not observed in this age group. In older children over 10 years of age, tumors were more common – with mostly teratoma or other germ cell tumors, followed by epithelial tumors. Moreover, acute or chronic ovarian torsion was observed in all age groups. In general, ovarian tumors were much larger in size than ovarian cysts or twisted ovaries and eventually showed tumor marker expression of AFP or ß-HCG. Simple ovarian cysts or twisted ovaries were smaller in size. Surgery for all ovarian lesions should aim to preserve healthy ovarian tissue by performing partial ovariectomy. Conclusions In adolescent girls with acute abdominal pain, immediate laparoscopy should be performed to rule out ovarian torsion. Careful imaging evaluation and the assessment of tumor markers should be performed in painless ovarian lesions to indicate an adequate surgical ovarian-sparing approach.

Torsion of the fallopian tube and acute pelvic pain: an unusual presentation of genital tuberculosis

2008 ◽  
Vol 89 (6) ◽  
pp. 1810-1811 ◽  
Author(s):  
Tirso Perez-Medina ◽  
Beatriz Bueno ◽  
Teresa Redondo ◽  
Isabel Gallego ◽  
José Bajo-Arenas
Keyword(s):  
Fallopian Tube ◽  
Pelvic Pain ◽  
Unusual Presentation ◽  
Genital Tuberculosis ◽  
Acute Pelvic Pain
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