scholarly journals Isolated fallopian tube torsion: A challenge for the timely diagnosis and treatment

2015 ◽  
Vol 143 (7-8) ◽  
pp. 471-475 ◽  
Author(s):  
Radoica Jokic ◽  
Jovan Lovrenski ◽  
Aleksandra Lovrenski ◽  
Velicko Trajkovic
Keyword(s):  
Fallopian Tube ◽  
Color Doppler ◽  
Lower Abdominal Pain ◽  
Longitudinal Axis ◽  
Diagnosis And Treatment ◽  
Laboratory Findings ◽  
Chronic Appendicitis ◽  
Timely Diagnosis ◽  
Whirlpool Sign ◽  
The Right

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.

scholarly journals Computed Tomography Appearance of the “Whirlpool Sign” in Ovarian Torsion

2021 ◽  
Vol 5 (4) ◽  
pp. 468-469
Author(s):  
Joshua Livingston ◽  
Savannah Gonzales ◽  
Mark Langdorf
Keyword(s):  
Computed Tomography ◽  
Lower Abdominal Pain ◽  
Cystic Mass ◽  
Ovarian Torsion ◽  
Venous Flow ◽  
Contrast Enhanced ◽  
Whirlpool Sign ◽  
Ovarian Pathology ◽  
The Right ◽  
Enhanced Computed Tomography

Case Presentation: A 28-year-old female presented to the emergency department complaining of right lower abdominal pain. A contrast-enhanced computed tomography (CT) was done, which showed a 15-centimeter right adnexal cyst with adjacent “whirlpool sign” concerning for right ovarian torsion. Transvaginal pelvic ultrasound (US) revealed a hemorrhagic cyst in the right adnexa, with duplex Doppler identifying arterial and venous flow in both ovaries. Laparoscopic surgery confirmed right ovarian torsion with an attached cystic mass, and a right salpingo-oophorectomy was performed given the mass was suspicious for malignancy. Discussion: Ultrasound is the test of choice for diagnosis of torsion due to its ability to evaluate anatomy and perfusion. When ovarian pathology is on the patient’s right, appendicitis is high in the differential diagnosis, and CT may be obtained first. Here we describe a case where CT first accurately diagnosed ovarian torsion by demonstrating the whirlpool sign, despite an US that showed arterial flow to the ovary. Future studies should determine whether CT alone is sufficient to diagnose or exclude ovarian torsion.

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 Heterotopic pregnancy: a case report

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Tamer Ali ◽  
Mohamed A. Tawab ◽  
Mona Abdel Ghaffar ElHariri ◽  
Alaa A. Ayad
Keyword(s):  
Abdominal Pain ◽  
Adnexal Mass ◽  
Stable Condition ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
First Trimester ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Laboratory Findings ◽  
The Right

Abstract Background Heterotopic pregnancy describes the occurrence of two pregnancies in different implantation sites simultaneously, which is rare, yet it is a challenge to diagnose such a problem due to complex clinical and laboratory findings. In the current study, we present a case of first trimester heterotopic pregnancy diagnosed by ultrasound (US) and magnetic resonance imaging (MRI) and was managed successfully. Case presentation A 22-year-old primigravida lady with spontaneous pregnancy was presented by increasing lower abdominal pain for 5 days with brownish vaginal discharge, nausea, and vomiting episodes. Trans-abdominal and endovaginal ultrasound was performed and revealed a viable intrauterine pregnancy of 8 weeks and 1 day, associated with a heterogeneous complex right adnexal mass. MR imaging revealed a right adnexal mass intimately anterior to the normal right ovary. Laparascopy was done; it revealed a distended right fallopian tube with pregnancy while the right ovary was not seen (impeded in the pouch of Douglas), and right salpingectomy was done. The specimen was sent for histopathology. The patient tolerated the procedure well and was then taken to the recovery room in stable condition. The histopathological report confirmed the diagnosis of ectopic pregnancy. Conclusion However, heterotopic is a rare condition, any pregnant woman presenting with alarming abdominal pain and adnexal abnormality; heterotopic pregnancy should be among the differential diagnosis possibilities. The patient should be thoroughly investigated using ultrasound and MRI if needed, to exclude this rare diagnosis and allow on-time proper management.

Covid-19: An update on the clinical features, diagnosis, and treatment strategies.

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Manan Abdulrahman Alhkbany
Keyword(s):  
Treatment Strategies ◽  
The Elderly ◽  
Diagnosis And Treatment ◽  
Transmission Method ◽  
Laboratory Findings ◽  
Health Crisis ◽  
New Public Health ◽  
Cell Counts ◽  
White Blood Cell Counts ◽  
The Right

: The Coronavirus disease 2019 (COVID-2019) has emerged as a new public health crisis with the WHO officially declaring it as a pandemic on 30 January 2020. In December 2019, the virus originated in bats and was transmitted to humans through an unknown intermediary animal in Wuhan, Hubei province, China. As of 18 May 2020, there are 4,730,968 reported cases of Covid-19, with 315,488 deaths. Direct contact among individuals is the most common transmission method, primarily through droplets released during coughing or sneezing. The incubation period of the virus oscillates between 2 to 14 days. The commonly reported symptoms include fatigue, sore throat, cough, and fever. Most of the people are asymptomatic or show mild symptoms. The elderly individuals and people with comorbidities show severe symptoms. The disease is diagnosed by using the real-time reverse transcription-polymerase chain reaction (RT-PCR) testing method. A blood test is also used to detect the antibodies to the virus, which are usually released after infection. The typical laboratory findings indicate elevated C-reactive proteins (CRP) with normal or low white blood cell counts; the chest CT scan demonstrates ground-glass opacities (GGO) and bilateral pneumonia in most patients. Supportive treatment is available, and research on the right treatment using existing drugs is ongoing. Several pharmaceutical companies and research institutions are focusing on the development of a vaccine. The review summarizes and provides an update on the pathogenesis, diagnosis, and treatment strategies in the management of Covid-19.

Torsion of ovarian endometrioma in pregnancy: a case report and review of the literature

2019 ◽  
Vol 49 (3) ◽  
pp. 221-223
Author(s):  
Dingchao Hua ◽  
Peng Zhao ◽  
Lianyun Jiang
Keyword(s):  
Lower Abdominal Pain ◽  
Exploratory Laparotomy ◽  
Acute Onset ◽  
Diagnosis And Treatment ◽  
Adnexal Torsion ◽  
Surgical Emergencies ◽  
Pelvic Ultrasonography ◽  
Logical Method ◽  
The Right ◽  
Resource Conditions

Adnexal torsion induced by an endometrioma has seldom been reported. Because of its rarity and its complexity in respect of fetal health during pregnancy, the diagnosis and treatment is challenging. We report a 25-year-old primigravida in the eighth week of gestation presenting with acute onset lower abdominal pain. A pelvic ultrasonography showed an intrauterine single viable embryo with a right ovarian cyst measuring 6 × 6 cm in diameter. Exploratory laparotomy revealed torsion of the right adnexa by 360°. After a right adnexectomy was performed, the patient proceeded to full-term pregnancy. Adnexal torsion is defined as rotation of > 45° in the long axis of the adnexae. Its occurrence during gestation is reported as 2%, accounting for 2.7% of surgical emergencies in pregnant women. Most cases are caused by dermoid and functional ovarian cysts. Because of the rarity of torsion induced by an endometrioma, the diagnosis and treatment are challenging. In poor-resource conditions, a diagnostic laparoscopy (or laparotomy) remains a logical method of diagnosis, offering simultaneous therapeutic options.

scholarly journals Isolated fallopian tube torsion with paraovarian cysts: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liang Qian ◽  
Xue Wang ◽  
Dingheng Li ◽  
Songyi Li ◽  
Jiashan Ding
Keyword(s):  
Abdominal Pain ◽  
Literature Review ◽  
Fallopian Tube ◽  
Lower Abdominal Pain ◽  
Histopathological Diagnosis ◽  
Common Procedure ◽  
Delay In Diagnosis ◽  
Paraovarian Cyst ◽  
History Of ◽  
The Right

Abstract Background Isolated fallopian tube torsion (IFTT) is a rare cause of gynecological acute abdomen, is easily misdiagnosed and often has a delay in diagnosis. IFTT with paraovarian cysts is most frequently reported in studies. Here, we reported a patient diagnosed with IFTT associated with a paraovarian cyst, and we conducted a literature review for IFTT, aiming to identify valuable information that will be helpful for diagnosis and treatment for fallopian tube torsions. Case presentation A 13-year-old girl presented with a 10-day history of right lower abdominal pain that worsened 2 days before presentation. On presentation, ultrasound showed a 5.8 * 5.5 cm hypoechoic cyst adjacent to the right ovary, and between the cyst and ovary, a tortuous thickened tube was visualized. Laparoscopy revealed a triple torsion of the right fallopian tube with a 6-cm paraovarian cyst, and tubal conservation surgery was performed. The postoperative course was uneventful. Histopathological diagnosis revealed serous papillary cystadenoma. Conclusion Paraovarian cystic dilatation often occurs in adolescence and can induce fallopian torsion when the size of the cyst reaches 5-cm. In our review, the median age of patients diagnosed with IFTT with paraovarian cysts was 15 years old, and the main clinical manifestation was emergency abdominal pain. The associated symptoms were variable, and vomiting was the most commonly associated symptom. Salpingectomy was the most common procedure performed; however, timely surgical intervention can effectively avoid salpingectomy.

scholarly journals Primary Hyperparathyroidism Caused by Single Parathyroid Adenoma

2018 ◽  
Vol 35 (9-10) ◽  
pp. 236-40
Author(s):  
Jose R. L. Batubara ◽  
Paruhum T. Siregar ◽  
M. Lutfi ◽  
Daniel Makes ◽  
Wawan Hermawan
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Ultrasound Examination ◽  
Color Doppler ◽  
Roentgenologic Examination ◽  
Laboratory Findings ◽  
First Case ◽  
Pathologic Fractures ◽  
The Right

Primary hyperparathyroidism is rarely found in children under sixteen years old. We report the first case seen at the Department of Child Health, Medical School, University of Indonesia, Jakarta. This 15-year old girl was admitted to the Department, referred by an orthopedic surgeon because of pathologic fractures suspected to be caused by hyperparathyroidism. The physical examination was unremarkable, and the laboratory findings showed increased level of parathyroid hormone. Roentgenologic examination showed lytic skull lesions, loss of the lamina dura of the dentis, subperiosteal resorption of the symphysis and generalized osteoporosis with pathologic fractures. Color Doppler USG using a high resolution ultrasound examination was performed to find the etiology of primary hyperparathyroidism. The result revealed single parathyroid adenoma in the right superior region measuring 2.7 x 1.7 x 1 cm. The clinical manifestation and laboratory findings showed improvement following surgery.

scholarly journals Torsion of the uterine appendages in a 12-year-old girl

2021 ◽  
Vol 25 (3) ◽  
pp. 220-223
Author(s):  
A. A. Bebenina ◽  
M. A. Chundokova ◽  
M. A. Golovanev
Keyword(s):  
Fallopian Tube ◽  
Surgical Intervention ◽  
Internal Organs ◽  
Chronic Appendicitis ◽  
Painful Sensation ◽  
Uterine Appendage ◽  
Therapeutic Measures ◽  
Surgical Tactics ◽  
The Right ◽  
Selection Of

Introduction. The uterine appendage torsion (UAT) is an urgent pathology accompanied by a painful abdominal syndrome and requiring urgent diagnostic and therapeutic measures. In childhood, UAT develops mainly due to organic causes and due to the specific location of internal organs in children. The literature data on organ-preserving surgeries in the long-lasting UAT is very controversial and dubious. There are no objective criteria for assessing ovarian viability after detorsion what impacts the selection of surgical intervention tactics - unjustified adnexectomy may be performed.Clinical case. Girl P., 12 years old, was admitted to the hospital with a clinical picture of long-lasting torsion of the uterus appendages. Right uterine appendages were detorsed. The child was under observation. In two years, laparoscopic appendectomy was performed for chronic appendicitis. When examining pelvic organs, the right ovary was found reduced in size compared to the left one; there were no macroscopically visible changes; single follicles were visualized in it; the fallopian tube was not changed.Conclusion. A painful sensation before surgery indicates that the uterus appendages are viable; if there is no abdominal pain, necrosis of the ovary and fallopian tube may be suspected. A surgical tactics is chosen on making a comprehensive analysis of clinical and instrumental findings.

scholarly journals A rare case of fallopian tube lymphangioma

2020 ◽  
Vol 9 (12) ◽  
pp. 5169
Author(s):  
Srikala Doddareddy ◽  
Shravya Manohar ◽  
Sumana Manohar
Keyword(s):  
Fallopian Tube ◽  
Rare Case ◽  
Lymphatic System ◽  
Abdominal Mass ◽  
Lower Abdominal Pain ◽  
Neck Region ◽  
Head And Neck Region ◽  
Rare Lesion ◽  
The Right ◽  
Palpable Abdominal Mass

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.

scholarly journals Torsion of Hydrosalpinx with Concurrent Acute Cholecystitis: Case Report and Review of Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Preeti R. John ◽  
Amelia M. Pasley
Keyword(s):  
Abdominal Pain ◽  
Acute Cholecystitis ◽  
Fallopian Tube ◽  
Bladder Wall ◽  
Age Groups ◽  
Lower Abdominal Pain ◽  
Abdominal Ultrasound ◽  
Acute Calculous Cholecystitis ◽  
Upper Abdominal ◽  
The Right

Introduction.Isolated torsion of the Fallopian tube is an uncommon cause of acute lower abdominal pain and can occur in women of all age groups. Cholecystitis is a frequent cause of upper abdominal pain. We present an unusual case with the presence of these two distinct pathological entities occurring concurrently in the same patient, causing simultaneously occurring symptoms. To our knowledge, this is the first reported presentation of such a case.Methods.We describe a 34-year-old premenopausal woman who presented with right sided upper and lower abdominal pain and nausea. Abdominal ultrasound (US) revealed acute cholecystitis. Vaginal US was suggestive of right hydrosalpinx. Intravenous antibiotics were administered and consent was obtained for operative intervention. During laparoscopy, the right Fallopian tube with hydrosalpinx was noted to be twisted three times. The right ovary appeared normal. The gall bladder wall was thickened and inflamed. Laparoscopic right salpingectomy and cholecystectomy were performed.Results.Surgical pathology revealed hydrosalpinx with torsion and acute calculous cholecystitis. The patient had an uneventful postoperative course and was discharged home on the first postoperative day. Her symptoms resolved after the procedure.Conclusions.In women with abdominal pain, both gynecologic and nongynecologic etiologies should be considered in the differential diagnoses. Concurrent presence of symptomatic gynecologic and nongynecologic intra-abdominal pathology is rare. Isolated Fallopian tube torsion is rare and is associated most often with hydrosalpinx. Some torqued Fallopian tubes can be salvaged. Laparoscopy is useful in management of both Fallopian tube torsion and cholecystitis.

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