title: Thirteen cases of isolated tubal torsions associated with hydrosalpinx in children and adolescents, proposal for conservative management: retrospective review and literature survey.
abstract: OBJECTIVE
  Isolated tubal torsion associated with hydrosalpinx is a rare pathology. Our goal was to analyze the clinical and imaging features and discuss the different treatment options available.
  
  
  METHODS
  We retrospectively reviewed all the cases of adnexal torsion treated in our department of pediatric surgery over a 10-year period. We searched 2 electronic databases (Medline and Sciencedirect) and targeted reports published during the same period using the key words tubal torsion and hydrosalpinx.
  
  
  RESULTS
  A total of 13 cases, 6 from our hospital and 7 in the medical literature, were identified and analyzed. In 9 (69%) of 13 cases (n = 9/13), torsion and hydrosalpinx occurred on the left fallopian tube. Salpingectomy was performed in 11 of the patients. The resected tubes showed the persistence of ciliated cells associated with signs of moderate ischemic infarction in 50% (n = 3/6) of the cases.
  
  
  CONCLUSIONS
  Isolated tubal torsion associated with hydrosalpinx is too often misdiagnosed and treated by salpingectomy regardless of the negative impact on the future reproductive potential of our young patients. As is commonly advocated for ovarian salvage in adnexal torsions, tubal conservation should be favored when possible.
authors.affiliation: Department of Obstetrics Gynecology Reproduction and Foetal Medecine, CHU de Nice, L'Archet hospital, 151 route Saint-Antoine de Ginestière 06200 Nice, France. samirboukaidi@hotmail.com
authors.forename: Samir Alexandre
authors.initials: SA
authors.lastname: Boukaidi
authors.forename: Jerome
authors.initials: J
authors.lastname: Delotte
authors.forename: Henri
authors.initials: H
authors.lastname: Steyaert
authors.forename: Jean Stéphane
authors.initials: JS
authors.lastname: Valla
authors.forename: Christophe
authors.initials: C
authors.lastname: Sattonet
authors.forename: Jerome
authors.initials: J
authors.lastname: Bouaziz
authors.forename: André
authors.initials: A
authors.lastname: Bongain
mesh_terms: D000293:Adolescent; D000714:Anastomosis, Surgical; D002648:Child; D004487:Edema / Q000209:etiology; D005184:Fallopian Tube Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000517:prevention & control; D059351:Organ Sparing Treatments / Q000379:methods*; D017699:Pelvic Pain / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D058994:Salpingectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D024162:Second-Look Surgery; D013536:Suture Techniques; D014102:Torsion Abnormality / Q000175:diagnosis / Q000601:surgery*; D019564:Unnecessary Procedures