scholarly journals Isolated twisted hematosalphinx misleading with ovarian cyst 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.

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Babatola Bakare ◽  
Olumide Akadiri ◽  
Akinyemi Akinsoji Akintayo

Torsion of ovarian cyst is a common cause of acute abdomen especially in women of reproductive age-group. It commonly presents with colicky abdominal pain associated with nausea and vomiting. It could however mimic acute intestinal obstruction. The patient was a 32-year-old multipara with no previous history of pelvic or abdominal surgery. She was admitted with colicky lower abdominal pain associated with repeated episodes of vomiting and nausea. Laboratory investigations were essentially normal. Abdominopelvic USS showed a hypoechoic mass lesion in the left adnexium measuring 7.1 × 5.5 cm; surrounding bowel loops were hypoactive, dilated, and fluid filled. Diagnosis of acute abdomen secondary to suspected torsion of ovarian cyst was made. Management began for acute abdomen with intravenous hydration, prophylactic antibiotics, and analgesics. An emergency laparotomy revealed about 6 cm defect in the left broad ligament in which a 20 cm segment of terminal ileum was encased. Liberation of the ileal segment was done and the broad ligament defect closed. Bowel obstruction requires high index of suspicion in a patient with acute abdomen due to suspected torsion ovarian cyst most especially in the absence of previous pelvic or abdominal surgery.


2020 ◽  
Vol 2 (2) ◽  
pp. 87-90
Author(s):  
Sunita Maharjan ◽  
Ganesh Dangal ◽  
Aruna Karki ◽  
Hema Pradhan ◽  
Ranjana Shrestha ◽  
...  

Ovarian cyst torsion (also termed as adnexal torsion) refers to partial or complete rotation of the ovary and a portion of fallopian tube along with its supply to vascular pedicle. It occurs commonly in females of all age group, more on the right side (60%) and often with acute lower abdominal pain lasting for few hours up to 24 hours. Ovarian cyst torsion is one of the devastating conditions hampering blood supply of ovary which may lead to total necrosis of ovarian tissue like in our case. Delayed diagnosis and management can lead to various complications. Here, we present a case of 46 years old perimenopausal female, para 2, living 2 who presented to our emergency department with complain of sudden onset severe pain abdomen since morning. Emergency exploratory laparotomy was done due to high clinical suspicion of torsion based on previous ultrasound finding of ovarian cyst done a day prior to the presentation. On intraoperative finding, the cyst was already necrosed. Due to timely diagnosis and management by emergency laparotomy, anticipated complications were reduced.    


2021 ◽  
Vol 6 (1) ◽  
pp. 6-10
Author(s):  
Oana Denisa Balalau ◽  
Ileana Maria Conea ◽  
Nicolae Bacalbasa ◽  
Anca Silvia Dumitriu ◽  
Stana Paunica ◽  
...  

Ovarian cyst is the most common female gynecological pathology and it is characteristic of reproductive age. Its rupture causes the sudden onset of pelvic-abdominal pain, often associated with physical exertion or sexual contact. The differential diagnosis is made with other causes of lower abdominal pain: ectopic pregnancy, adnexal torsion, pelvic inflammatory disease or acute appendicitis. The clinical picture may vary depending on the type of ruptured cyst. Dermoid cyst causes severe symptoms due to chemical peritonitis that occurs in response to extravasation of sebaceous contents in the peritoneal cavity. Surgical treatment is indicated for complicated forms of cystic rupture. Most cases have self-limiting, quantitatively reduced bleeding and spontaneous resorption within a few days. Patients diagnosed with ovarian cyst are recommended for regular ultrasound monitoring to prevent complications such as cystic rupture or adnexal torsion. The identification of any ovarian tumor mass in the woman at menopause requires further investigation to rule out the causes of malignancy.


2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Berat Dilek Demirel ◽  
Sertac Hancioglu ◽  
Unal Bicakci ◽  
Ender Ariturk ◽  
Ferit Bernay

Isolated fallopian tube torsion is a rare cause of acute abdomen mostly seen in women of reproductive age. It is often diagnosed during surgery. In this study we aimed to present a case of isolated fallopian tube torsion in a child. An 11-year-old girl presented with abdominal pain. With the help of radiological evaluation we diagnosed. It should be kept in mind that even if ovarian blood flow is normal in girls with abdominal pain, it may be an isolated tubular torsion and requires immediate intervention.


Author(s):  
Srikala Doddareddy ◽  
Shravya Manohar ◽  
Sumana Manohar

Lymphangioma of the fallopian tube is a very rare lesion, usually present as benign lesions of the lymphatic system. They are generally diagnosed incidentally, may be asymptomatic or present as a palpable abdominal mass. Lymphangiomas are usually seen in the head and neck region, intra-abdominal localisation is rare. A very limited number of cases of fallopian tube lymphangiomas have been reported. We present an extremely rare case of unilateral fallopian tube lymphangioma (right side) in a 32 year old parous lady who was presented to us with right lower abdominal pain. Clinically no significant findings were noted. CECT abdomen reported as a probable endometriotic cyst. On laparoscopy she was found to have a cystic lesion arising from the right fallopian tube. Patient underwent right salphingo-oophorectomy and histopathology reported as lymphangioma of the fallopian tube.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Valeria Fiaschetti ◽  
Aurora Ricci ◽  
Angela Lia Scarano ◽  
Valeria Liberto ◽  
Daniele Citraro ◽  
...  

Corpus luteum cyst rupture with consequent hemoperitoneum is a common disorder in women in their reproductive age. This condition should be promptly recognized and treated because a delayed diagnosis may significantly reduce women’s fertility and intra-abdominal bleeding may be life-threatening. Many imaging modalities play a key role in the diagnosis of acute pelvic pain from gynecological causes. Ultrasound study (USS) is usually the first imaging technique for initial evaluation. USS is used to confirm or to exclude the presence of intraperitoneal fluid but it has some limitations in the identification of the bleeding source. Contrast-enhanced computed tomography (CT) is the imaging modality which could be used in the acute setting in order to recognize gynecological emergencies and to establish a correct management. Magnetic resonance imaging (MRI) nowadays is the most useful technique for studying the pelvis but its low availability and the long acquisition time of the images limit its usefulness in characterization of acute gynecological complications. We report a case of a young patient with hemoperitoneum from hemorrhagic corpus luteum correctly identified by transabdominal USS and contrast-enhanced CT.


2020 ◽  
Vol 7 (2) ◽  
pp. 91-94
Author(s):  
Namita Sindan ◽  
Adheesh Bhandari

An ovarian cyst is usually a relatively large, fluid-filled cystic structure (diameter greater than 3 cm) that originates from the surface or inside the ovary. Ovarian cysts can be simple or complex, depending on their internal material. Hemorrhagic ovarian cysts (HOCs) are commonly seen in clinical practice. Most of them resolve naturally during follow-up except in a minority of cases in which surgical intervention is needed. Ovarian torsion indicates partial or complete rotation of the ovary and a portion of the fallopian tube along its supplying vascular pedicle. It usually occurs in the reproductive age group, more on the right side (about 60%), and often presents with acute lower abdominal pain lasting for a few hours to 24 hours. It is one of the harmful conditions, hampering blood supply of ovary which may rise to overall necrosis of ovarian tissue and other difficulties, if not identified and managed in time. We present a case of a huge hemorrhagic ovarian cyst managed in the Department of Gynecology and Obstetrics, Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal.


Author(s):  
Nadah Zafar

ABSTRACT In an emergency setting pelvic ultrasound is the tool of choice for the evaluation of the patients presenting with acute pelvic pain. It has a high sensitivity and specificity for detection of pelvic pathology, low cost, widespread availability and lack of ionizing radiation. This article presents a variety of case scenarios regarding the nonpregnant female of reproductive age presenting with acute pelvic and lower abdominal pain. By using illustrative images, the reader will be able to differentiate between the most common causes of abdominal and/or pelvic pain and identify typical B-mode and color Doppler ultrasound findings and CT images that require immediate treatment, while minimizing the performance of unnecessary additional imaging and invasive procedures. How to cite this article Zafar N, Kupesic Plavsic S. Role of Ultrasound in the Evaluation of Acute Pelvic Pain in Nonpregnant Reproductive Age Patients. Donald School J Ultrasound Obstet Gynecol 2012;6(2):207-217.


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