Isolated torsion of fallop tube during early pregnancy

Abstract

Isolated torsion of the fallopian tube is an un common event It is a difficult condition to evaluate clinically and surgery is often necessary to establish the diagnosis. A 23-year old, nullipar woman was admitted with severe abdominal pain in the right lower quadrant associated with nause and vomiting for 3 days. Abdominal examination revealed diffuse, lower abdominal tenderness with guarding and rebound mainly in the right lower quadrant and the abdomen showed muscular rigidity, suggesting peritonism. Pelvic ultrasound showed that intrauterin viable fetus and their crown-rump lengths were 13 mm corresponding to 7 weeks 5 days of gestation and right adnexal unilocular cyst approximately 46 x 30 mm in diameter with no solid areas and surrounded by a thin wall was found. In the differential diagnosis acute appendicitis is considered. During laparotomy a swollen hyperemic right tuba was found, and the appendix was hyperemic. Appendectomy and right salpengectomy were performed. Histopathology confirmed periapendicit, and right tubal necrosis.