Isolated torsion of the fallopian tube with hydrosalpinx mimicking a multiloculated ovarian cyst: Whirlpool sign on preoperative sonography and MRI

2013 ◽  
Vol 42 (1) ◽  
pp. 45-48 ◽  
Author(s):  
Ramazan Aydin ◽  
Devran Bildircin ◽  
Ahmet Veysel Polat
2012 ◽  
Vol 10 (2) ◽  
pp. 153-154 ◽  
Author(s):  
P Rijal ◽  
H Pokharel ◽  
S Chhetri ◽  
T Pradhan ◽  
A Agrawal

A case of bilateral fimbrial cyst with torsion of right side is presented, occurring in a 32 year old female. She presented in outpatient department with pain abdomen and feeling of mass in lower abdomen since six months. Initial assessment of ovarian cyst was made. Ultrasound showed cystic structures in left adnexa and complex cyst in right adnexa. Laprotomy was performed and bilateral fimbrial cysts in fallopian tubes were identified with torsion on right side which was subsequently confirmed on histopathology. Although huge fimbrial cysts with torsion of fallopian tube is rare, it should be considered in differential diagnosis of abdominal mass with pain in females.DOI: http://dx.doi.org/10.3126/hren.v10i2.6588 Health Renaissance 2012; Vol 10 (No.2); 153-154 


2019 ◽  
Vol 52 (6) ◽  
pp. 397-402 ◽  
Author(s):  
Matheus Menezes Gomes ◽  
Larissa Sobral Cavalcanti ◽  
Rainier Luz Reis ◽  
Eduardo Just da Costa e Silva ◽  
Joanna Braynner Dutra ◽  
...  

Abstract Adnexal torsion is characterized by partial or complete rotation of the suspensory ligament of the ovary and its corresponding vascular pedicle, resulting in vascular impairment that can culminate in hemorrhagic infarction, as well as necrosis of the ovary and fallopian tube. Because there are myriad causes of acute pelvic pain, the differential diagnosis of ovarian torsion is often challenging. Consequently, radiologists should be familiar with the main imaging findings. In this regard, there are typical signs of ovarian torsion on magnetic resonance imaging, including increased ovarian volume with stromal edema and peripheral distribution of the ovarian follicles, as well as thickening of the fallopian tube, an adnexal mass (causal factor) that shifts toward the midline, and the classic, pathognomonic “whirlpool sign”. The objective of this essay was to review and illustrate the various magnetic resonance imaging findings in ovarian torsion.


Author(s):  
Vaibhav Khairnar ◽  
Shalini Mahana Valecha ◽  
Pandeeswari .

Normal or chronically inflamed fallopian tube can undergo torsion and present as acute abdomen, simulating clinically as ectopic gestation. Torsion of the fallopian tube is less frequent but significant cause of lower abdominal pain in reproductive age women that is difficult to recognize preoperatively. Authors present a rare case of hematosalpinx with torsion at its pedicle with hemoperitonium who presented as 28 years old female with acute abdomen that was successfully treated. In cases presenting with hemoperitoneum diagnosis of ruptured ectopic pregnancy should be made unless proved otherwise during reproductive age. Rarely ruptured ovarian cyst may also be a cause. Unfortunately, hematosalpinx sometimes can undergo torsion due to circulatory imbalance and can present as hemoperitoneum and circulatory collapse due to rupture. There have been no specific symptoms, clinical findings, imaging or laboratory characteristics identified for this condition. Imaging findings are non-specific in the preoperative diagnosis of torsed fallopian tubes. Therefore, most of cases with isolated fallopian tubal torsion had a delayed diagnosis and a subsequent delay of timely intervention that may result in failure to save tubal function. Torsion of tube can lead to hematosalpinx, hemoperitonium and necrosis of tube which necessitates urgent surgical management. This case report describes a twisted hematosalpinx presentation without any predisposing high-risk factors. A tubal torsion should be suspected in females with acute pelvic pain, of any age group. An early diagnosis and treatment are required to prevent complications. This rare case may highlight a new insight into pathogenesis of tubal torsion associated with hematosalpinx.


2015 ◽  
Vol 143 (7-8) ◽  
pp. 471-475 ◽  
Author(s):  
Radoica Jokic ◽  
Jovan Lovrenski ◽  
Aleksandra Lovrenski ◽  
Velicko Trajkovic

Introduction. Isolated torsion of the fallopian tube is a rare cause of acute lower abdominal pain and infrequent indication for surgical treatment. Case Outline. A 16-year-old girl was referred to the hospital due to the non-specific symptoms over period of a few months and pain acutization in the right infraumbilical region lasting for two days. Complete laboratory analyses were normal. Ultrasound examination revealed a round mass (23?14 mm) within the right fallopian tube with color Doppler whirlpool sign, normal ovary, and a simple ipsilateral paratubal cyst (50x40 mm). Laparoscopy showed a dilated and two times torquated right fallopian tube, as well as signs of chronic appendicitis. The tube was twisted about its longitudinal axis and it was livid, but not gangrenous. After appendectomy, fallopian tube was detorquated, cyst extracted and preservation of the tube was performed. Postoperatively, antibiotic therapy was administered based on antibiogram. On follow-up examinations within the next four months postoperative course was uneventful. Conclusion. Since there are no pathognomonic symptoms, clinical or laboratory findings, diagnosis of this condition is challenging. Familiarity with Doppler whirlpool sign can enable a timely diagnosis and treatment of isolated fallopian tube torsions. However, the diagnosis is rarely made before operation. Unlike in our case, surgery is often performed too late, and delay of intervention may result in failure to save the fallopian tube.


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