Torsion of the fallopian tube in an adolescent female: a case report.
BACKGROUND
Torsion of the fallopian tube is an infrequent but significant cause of acute lower abdominal pain in adolescent females that is difficult to recognize preoperatively, although prompt diagnosis and timely surgical treatment are vital to salvage the oviduct.


METHODS
A 17-yr-old virgin presented with sudden and severe right-sided lower abdominal pain with guarding and tenderness, fever, nausea, and vomiting at mid-cycle. Ultrasound scan showed a right ovarian cyst measuring 3 cm in diameter and a normal appendix. There was no leucocytosis. Presumptive diagnosis was a cystic ovarian follicle with ovulatory pain. Her condition improved but did not resolve with supportive treatment. At laparotomy, the right fallopian tube was twisted completely, distended with blood, and necrotic, with a small fimbrial cyst. The left tube, ovaries, appendix, and uterus were normal. Right salpingectomy was performed. Histologic examination revealed diffuse hemorrhagic infarction of the tube and a cyst of the hydatid of Morgagni. She remains well at follow-up.


CONCLUSIONS
Unless a high index of suspicion is maintained for torsion of the fallopian tube in adolescent females, this disorder may not be detected until after tubal destruction.
Rizk
Diaa E E
DE
Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates. rizk.diaa@uaeu.ac.ae
Lakshminarasimha
Brinda
B
Joshi
Sandhya
S
D000006:Abdomen, Acute / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D000293:Adolescent; D005184:Fallopian Tube Diseases / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D005187:Fallopian Tubes / Q000098:blood supply* / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007238:Infarction / Q000175:diagnosis*; D010535:Laparoscopy; D010048:Ovarian Cysts / Q000150:complications / Q000000981:diagnostic imaging; D014102:Torsion Abnormality; D016896:Treatment Outcome; D014463:Ultrasonography