title: Isolated torsion of the hydrosalpinx in a postmenopausal woman.
abstract: OBJECTIVE
  Isolated torsion of the fallopian tube is an uncommon cause of acute lower abdominal pain. It is often found in reproductive-age women and is found less in prepubertal and perimenopausal women.
  
  
  METHODS
  We describe a 70-year-old postmenopausal woman who presented with lower abdominal pain and discomfort. Ultrasonography revealed a well-defined, echo-free cystic mass measuring 5.3 cm x 5.8 cm without septations. Laparoscopic examination showed a dark-red, round-shaped cystic lesion that twisted at the right infundibulo-pelvic ligament site in the right adnexa area with adhesion to the posterior uterine surface and separation from the atrophic ovary.
  
  
  RESULTS
  The pathology study of the excised tumor showed hydrosalpinx with torsion. The patient was asymptomatic after the procedure. Torsion of the hydrosalpinx is rare in postmenopausal women. In postmenopausal women presenting with low abdominal pain with an adnexal mass, the gynecologist should contemplate possible torsion of the hydrosalpinx.
  
  
  CONCLUSIONS
  The case was unusual in the postmenopausal age group, making it a rare presentation of a rare entity. Laparoscopy could be a useful tool in diagnosing and treating isolated tubal torsion.
authors.affiliation: Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, ROC. dah1003@yahoo.com.tw
authors.forename: Dah-Ching
authors.initials: DC
authors.lastname: Ding
authors.forename: Senzan
authors.initials: S
authors.lastname: Hsu
authors.forename: Sheng-Po
authors.initials: SP
authors.lastname: Kao
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D000368:Aged; D003937:Diagnosis, Differential; D005184:Fallopian Tube Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D010052:Ovariectomy / Q000379:methods*; D017698:Postmenopause; D014102:Torsion Abnormality