title: Tubal endometrioma within a twisted fallopian tube: a clinically complex diagnosis.
abstract: BACKGROUND
  Endometriotic lesions affect the fallopian tubes in 6% of patients with endometriosis and adhesions involve the salpinges in 26%. Different studies report that 45%-70% of adolescents with chronic pelvic pain have endometriosis diagnosed at the time of laparoscopy.
  
  
  METHODS
  We report a case of an 18-year-old girl with a tubal torsion due to a tubal endometrioma. The endometriotic nodule before laparoscopy appeared to be located in the rectovaginal septum. At laparoscopy, a right fallopian tube torsion was visible and several adhesions were connecting the lesion to the pouch of Douglas' walls.
  
  
  CONCLUSIONS
  The tenacious adhesions, which welded the nodule to the walls of the pouch of Douglas, did not allow to distinguish at the MRI a tubal endometrioma from a rectovaginal endometriotic mass, justifying the false diagnosis.
authors.affiliation: Department of Gynecology and Obstetrics, Division of Gynecology, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: J M
authors.initials: JM
authors.lastname: Wenger
authors.forename: I
authors.initials: I
authors.lastname: Soave
authors.forename: G
authors.initials: G
authors.lastname: Lo Monte
authors.forename: P
authors.initials: P
authors.lastname: Petignat
authors.forename: R
authors.initials: R
authors.lastname: Marci
mesh_terms: D000293:Adolescent; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005184:Fallopian Tube Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005187:Fallopian Tubes / Q000473:pathology*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D014102:Torsion Abnormality / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery