scholarly journals A New Etiologic Factor for Adnexal Torsion: Congenital Omental Fenestrum

2016 ◽  
Vol 22 (1) ◽  
Author(s):  
Ulaş Fidan ◽  
Fahri Burçin Fıratlıgil ◽  
Mustafa Ulubay ◽  
Uğur Keskin ◽  
Ali Ergün
Keyword(s):  
Fallopian Tube ◽  
Lower Abdominal Pain ◽  
Pelvic Surgery ◽  
Etiologic Factor ◽  
Ischemic Damage ◽  
Adnexal Torsion ◽  
Future Fertility ◽  
Gynecologic Emergency ◽  
Fertility Problems ◽  
Delays In Diagnosis

<p>Torsion seen in ovary, fallopian tube or in both organs is one of the gynecologic emergency pathologies in patients suffering from acute lower abdominal pain, and it constitutes approximately 2.7% of gynecologic emergencies. Delays in diagnosis and treatment can cause ischemic damage, in that way can cause the risk of ovary, fallopian tube or both organs loss. Thus, it can result in fertility problems in people who are desiring future fertility.<br />Although the etiology is not totally known, it has been thought that torsion risk has been increasing in benign cystic teratomas and ovarian tumors. It can be also seen in congenital situations such as vitellointestinal duct anomaly and people who have undergone pelvic surgery.<br />In this article, a case for adnexal torsion developed in congenital omental fenestrum which is considered as a new factor for torsion etiology, was explained.</p>

scholarly journals A rare case of isolated fallopian tube torsion

2019 ◽  
Vol 8 (11) ◽  
pp. 4570
Author(s):  
Namrita Sandhu ◽  
Sanjay Singh
Keyword(s):  
Fallopian Tube ◽  
Rare Case ◽  
Iliac Fossa ◽  
Imaging Study ◽  
Rapid Diagnosis ◽  
Rare Occurrence ◽  
Adnexal Torsion ◽  
Transabdominal Ultrasonography ◽  
Ready Availability ◽  
Delays In Diagnosis

Isolated torsion of fallopian tube is a rare occurrence. Diagnostic difficulty gets compounded in adolescents because the most commonly used imaging study in young, usually sexually inactive, population is transabdominal ultrasonography which may show normal ovaries, leading clinicians to abandon a diagnosis of adnexal torsion. Other imaging modalities such as CT scan or MRI are less useful for a rapid diagnosis because of the risk of radiation exposure, cost, or lack of ready availability. Delays in diagnosis may increase the likelihood of necrosis of the fallopian tube which would result in salpingectomy as was the case in our case report. Here authors present one such case, wherein one 12 year old girl who attained menarche at 10 years of age presented with acute paraumblical pain and vomiting without any fever, bowel and bladder disturbances. On examination there was tenderness in right iliac fossa. Her USG report was unremarkable. She initially was put-on broad-spectrum antibiotics but without any amelioration of symptoms. Diagnosed as appendicitis by surgeon, she was taken up for laparoscopic appendicectomy. However, it turned out to be a case of fallopian tube torsion, wherein the tube had become gangrenous for which salpingectomy was done.

Diagnostic dilemma of isolated fallopian tube torsion

2021 ◽  
Vol 14 (7) ◽  
pp. e242682
Author(s):  
Michael Gerard Baracy Jr ◽  
Janie Hu ◽  
Holly Ouillette ◽  
Muhammad Faisal Aslam
Keyword(s):  
Acute Abdomen ◽  
Fallopian Tube ◽  
Differential Diagnoses ◽  
Adnexal Torsion ◽  
Normal Appendix ◽  
Diagnostic Dilemma ◽  
Perimenopausal Women ◽  
Adolescent Patients ◽  
History Of

Paratubal cysts are fluid-filled sacs that grow adjacent to the fallopian tube which can rarely result in torsion. Isolated fallopian tube torsion (IFTT) is a gynaecological emergency that warrants urgent laparoscopic detorsion to salvage the affected tube. IFTT has a proclivity to affect adolescents between the ages of 12 and 15 years and is rarely seen in premenarchal or perimenopausal women. Due to a lack of pathognomonical features, IFTT is difficult to diagnose. Adnexal torsion, including IFTT is a surgical diagnosis and no clinical or imaging criteria is sufficient to diagnose IFTT. Urgent laparoscopy and detorsion are required for preservation of the affected fallopian tube. However, given the diagnostic ambiguity, IFTT diagnosis is often delayed. IFTT should be included in the differential diagnoses for adolescent patients with acute abdomen when imaging demonstrates a normal appendix and ovaries. We report a 15-year-old girl with a 4-day history of abdominopelvic pain and bilateral paratubal cysts resulting in right IFTT.

scholarly journals Ruptured Right Cornual Pregnancy

2018 ◽  
Vol 13 (1) ◽  
pp. 51-53
Author(s):  
Shreesiya Pokhrel ◽  
Ganesh Dangal ◽  
Aruna Karki ◽  
Hema Kumari Pradhan ◽  
Ranjana Shrestha ◽  
...  
Keyword(s):  
Fallopian Tube ◽  
Uterine Cavity ◽  
Medical Abortion ◽  
Transabdominal Ultrasound ◽  
Missed Abortion ◽  
Hemodynamic Stability ◽  
Interstitial Pregnancy ◽  
Ectopic Gestation ◽  
Future Fertility ◽  
Β Hcg

The ectopic implantation is implantation of fertilized ovum outside the uterine cavity, ampulla of fallopian tube being the most common site. A cornual or interstitial pregnancy is an ectopic pregnancy that develops in the interstitial portion of the fallopian tube which is one of the most hazardous type of ectopic gestation. Treatment depends on the week of gestation at the time of diagnosis, level of serum β HCG, findings of ultrasonography, hemodynamic stability of the patient and the choice of future fertility. In this case report, we present a case which was previously misdiagnosed as a case of missed abortion at 8 weeks of gestation by transabdominal ultrasound and patient underwent medical abortion with  mefipristione and  misoprostolandafter 1 month presented with pain abdomen and was confirmed as extrauterine pregnancy by transabdominal ultrasound followed by surgical management.

Factors Associated With Operatively Confirmed Adnexal Torsion Among Pregnant Women – A Multicenter Cohort Study

2020 ◽  
Author(s):  
Misgav Rottenstreich ◽  
Ido Moran ◽  
Ayala Hirsch ◽  
Reut Rotem ◽  
Shunit Armon ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Pregnant Women ◽  
Clinical Laboratory ◽  
Multivariate Logistic Regression Analysis ◽  
Lower Abdominal Pain ◽  
Adnexal Torsion ◽  
Multicenter Cohort Study ◽  
Duration Of Symptoms ◽  
Ultrasound Findings ◽  
Previous Cesarean

Abstract Purpose The aim of this study was to investigate the association of clinical, laboratory, and ultrasound findings with the surgical diagnosis of adnexal torsion in a retrospective cohort of women operated for suspected torsion during pregnancy. Materials and Methods A multicenter retrospective study of pregnant women who underwent urgent laparoscopy for suspected adnexal torsion during 2004–2019 in three tertiary medical centers. Results Adnexal torsion was found in 143/208 (68.8 %) cases. Women with adnexal torsion had lower parity and lower rates of previous cesarean section, but higher rates of fertility treatments and multiple gestations, and were more likely to report right lower abdominal pain, with shorter duration of symptoms (< 24 hrs) and vomiting but not nausea. Women with adnexal torsion were found to have higher rates of sonographic findings suggestive of ovarian edema, while normal-appearing ovaries on ultrasound were more common in women without torsion. A multivariate logistic regression analysis showed that complaints of right abdominal pain were positively associated with adnexal torsion (aOR [95 % CI] 5.03 (1.45–17.49), while previous cesarean delivery and ultrasound findings of normal-appearing ovaries were negatively associated with adnexal torsion (aOR of 0.17 (0.05–0.52) and 0.10 (0.02–0.43), respectively). Conclusion Clinical characteristics and ultrasound findings may be incorporated into the emergency room workup of pregnant women with suspected adnexal torsion.

scholarly journals Unilateral Twin Ectopic Pregnancy in a Patient With a History of Multiple Sexually Transmitted Infections

2006 ◽  
Vol 2006 ◽  
pp. 1-3 ◽  
Author(s):  
Charles J. Rolle ◽  
Clifford Y. Wai ◽  
Roger Bawdon ◽  
Rigoberto Santos-Ramos ◽  
Barbara Hoffman
Keyword(s):  
Ectopic Pregnancy ◽  
Sexually Transmitted Infections ◽  
Fallopian Tube ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
Operative Trauma ◽  
Sexually Transmitted ◽  
Uncommon Presentation ◽  
Increased Risk ◽  
History Of

Background. The incidence of unilateral twin ectopic pregnancy is a rare condition. Several factors increase the risk of ectopic pregnancy, the most important of which is pelvic inflammatory disease, followed by operative trauma, congenital anomalies, tumors, and adhesions resulting in anatomically distorted fallopian tubes. We present a case of a woman with a history of four confirmed sexually transmitted infections (STIs) including Chlamydia trachomatis, Neisseria gonorrhoeae, herpes simplex virus 2, and Treponema pallidum. The case illustrates the potential impact of sexually transmitted infections (STIs) on the risk of a twin ectopic pregnancy. Case. A 24-year-old primigravida, presented with an unknown last menstrual period, lower abdominal pain, watery vaginal discharge, and vaginal spotting. During this hospitalization, serumβ-HCG testing was 263 mIU/mL and transvaginal ultrasonographic examination suggested a nonviable unilateral twin ectopic pregnancy. At exploratory laparotomy, a 10 cm mass involving the right fallopian tube and ovary was excised. Pathological evaluation of the specimen identified a monochorionic, diamnionic twin ectopic pregnancy within the fallopian tube. Conclusions Patients with a history of multiple (STIs) are known to be at risk for the development of chronic pelvic infection and postinflammatory scarring. The resulting distortion of the normal tubal anatomy leads to an increased risk of an uncommon presentation of ectopic pregnancy.

scholarly journals Management of hemoperitoneum due to rupture of the ovarian cyst

2021 ◽  
Vol 6 (1) ◽  
pp. 6-10
Author(s):  
Oana Denisa Balalau ◽  
Ileana Maria Conea ◽  
Nicolae Bacalbasa ◽  
Anca Silvia Dumitriu ◽  
Stana Paunica ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Ovarian Cyst ◽  
Lower Abdominal Pain ◽  
Physical Exertion ◽  
Sudden Onset ◽  
Reproductive Age ◽  
Adnexal Torsion ◽  
Ultrasound Monitoring ◽  
Chemical Peritonitis ◽  
Rule Out

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.

scholarly journals A rare case of ovarian torsion in a pregnant patient

2021 ◽  
Vol 11 (1) ◽  
pp. 255
Author(s):  
Swati Kumari
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Diagnostic Delay ◽  
Pregnant Patient ◽  
Ovarian Torsion ◽  
Adnexal Torsion ◽  
Venous Flow ◽  
Presenting Symptoms ◽  
Prompt Treatment ◽  
Gynecologic Emergency

Torsion of the ovary is the total or partial rotation of the adnexa around its vascular axis or pedicle. It is an uncommon cause of acute abdominal pain in females, and it is a gynecologic emergency. The majority of the cases present in the pregnant (22.7%) than in non-pregnant (6.1%) women. Diagnostic delay can result in loss of the ovary. This twisting initially obstructs venous flow, which causes engorgement and edema. The engorgement can progress until arterial flow is also compromised, leading to ischemia and infarction. The increased use of ovarian stimulation and assisted reproductive technology has led to an increase in the risk of adnexal torsion, particularly in pregnant women or women with ovarian hyperstimulation syndrome (OHSS). The differential diagnosis of adnexal torsion is particularly difficult in combination with OHSS or pregnancy, as abdominal pain, nausea and vomiting can be presenting symptoms of hyperstimulation or pregnancy as well. Here, we report a case of ovarian torsion occurring in pregnancy in which diagnostic delay occurred due to confusion with OHSS leading to oophorectomy. Fertility conservation may have been possible in case of earlier diagnosis and prompt treatment.

scholarly journals Adnexal Torsion after Isolated Salpingeal Torsion: An Undesired Complication of Conservative Management: A Case Report

2020 ◽  
Author(s):  
Eniola R. Ibirogba ◽  
Faheema Abduljalil Alshehabi ◽  
Afeefa Ashfaq Konchwalla ◽  
Mohammed Sobhy Badr Sobei ◽  
Amal Hassan Hassan Ismail
Keyword(s):  
Case Report ◽  
Fallopian Tube ◽  
Conservative Management ◽  
Clinical Laboratory ◽  
Reproductive Age ◽  
Adnexal Torsion ◽  
Lower Quadrant ◽  
Radiographic Findings ◽  
Clinically Significant ◽  
The Right

Objective: Isolated salpingeal torsion (IST) is a rare cause of acute abdomen in women of the reproductive age group. The lack of pathognomonic clinical, laboratory or radiographic findings makes early diagnosis a challenge. We describe a case of IST in a 13-year-old who suffered from a repeat torsion following initial conservative management. Case Report: A 13-year-old girl presented with acute right lower quadrant abdominal pain of insidious onset. Her past medical history was non-contributory and her initial workup was unremarkable. Exploratory laparoscopy subsequently revealed isolated torsion of the right fallopian tube which was detorted. She presented 10 months later with similar complaints and further workup demonstrated right adnexal torsion which was confirmed by laparoscopy; salpingo-oophorectomy was necessary due to gangrenous necrosis. Conclusion: Conservative management of fallopian tube torsion confers the advantage of fertility preservation but the risk of repeat torsion remains clinically significant.

scholarly journals Primary Fallopian Tube Carcinoma: A Case Report and Literature Review

2017 ◽  
Vol 5 (3) ◽  
pp. 344-348 ◽  
Author(s):  
Meral Rexhepi ◽  
Elizabeta Trajkovska ◽  
Hysni Ismaili ◽  
Florin Besimi ◽  
Nagip Rufati
Keyword(s):  
Fallopian Tube ◽  
Female Genital Tract ◽  
Lower Abdominal Pain ◽  
Ca 125 ◽  
Histopathological Diagnosis ◽  
Fallopian Tube Carcinoma ◽  
Rare Tumour ◽  
Initial Surgery ◽  
Primary Fallopian Tube Carcinoma ◽  
The Right

BACKGROUND: Primary fallopian tube carcinoma (PFTC) is a rare tumour of the female genital tract with an incidence of 0.1-1.8% of all genital malignancies, and it is very difficult to diagnose preoperatively, because of its non-specific symptomatology. In most cases, it is an intraoperative finding or a histopathological diagnosis. It is a tumour that histologically and clinically resembles epithelial ovarian cancer.CASE PRESENTATION: We are reporting a case of a 62-year-old, postmenopausal women with primary fallopian tube carcinoma of the right fallopian tube in stage IA. The patient has lower abdominal pain, watery vaginal discharge and repeated episodes of bleeding from the vagina. The clinical and radiological findings suggested a right adnexal tumour with elevated CA-125 levels. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy and peritoneal washing were performed. Pathologic confirmation of primary serous cystadenocarcinoma of the right fallopian tube was made. Peritoneal washings were negative for malignancy. FIGO stage was considered as IA, and the patient received no courses of chemotherapy and postoperative radiation because she refused it. Ten months after initial surgery, the patient is alive and in good condition.CONCLUSION: Cytoreduction surgery followed by adequate cycles of chemotherapy is an important strategy to improve patients’ prognosis.

scholarly journals Unilateral absence of ovary and fallopian tube

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Dan-Dan Wang ◽  
◽  
Ning-Ning Zhang ◽  
Qing Yang ◽  
Jiao Wang ◽  
...  
Keyword(s):  
Fallopian Tube ◽  
Mature Teratoma ◽  
Pelvic Surgery ◽  
Pathological Examination ◽  
Ovarian Teratoma ◽  
Pelvic Magnetic Resonance Imaging ◽  
Acute Pelvic Pain ◽  
Laparoscopic Cystectomy ◽  
History Of ◽  
The Right

A 19-year-old young woman was admitted to our Unit for irregular menstrual cycles within 40- to 60-day intervals for 7 months. She had no history of abdomino-pelvic surgery or acute pelvic pain. Pelvic magnetic resonance imaging revealed a right ovarian mass (Figure1A & B), measuring 6.0 cm X 5.1 cm X 5.0 cm. The patient underwent laparoscopy. At the laparoscopic examination, we evidenced a right ovarian teratoma about 6.0 cm X 6.0 cm and a small mesosalpinx cyst about 2.5 cm X 2.0 cm on the right fallopian tube (Figure 2A). On the left, neither fallopian tube nor ovary was detected (Figure 2B). We performed laparoscopic cystectomy and sutured residual ovarian tissues for hemostasis. Subsequent urinary ultrasonography demonstrated a normal urinary tract without any congenital anomaly. The pathological examination confirmed the diagnosis of mature teratoma and right mesosalpinx serous cyst. The patient was successfully discharged at the third day with no complications.

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