Isolated Fallopian Tube Torsion in Chronic Pelvic Pain: A Rare Case

Seyedeh Azam  Pourhoseini; Nona  Sabeti; Ezat  Hajmollarezaei

doi:10.18502/jri.v26i4.21092

Seyedeh Azam Pourhoseini Family and the Youth of Population Support Research Center, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Nona Sabeti Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran
Ezat Hajmollarezaei Family and the Youth of Population Support Research Center, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

DOI: https://doi.org/10.18502/jri.v26i4.21092

Keywords: Chronic pelvic pain, Fallopian tube torsion, Hydrosalpinx, Laparoscopy

Abstract

Background: Abdominal pain is a frequent complaint among women presenting to gynecological and surgical emergency departments. The management approach depends on the severity, nature, and possible underlying causes of the pain, ranging from observation to urgent surgical intervention. One important cause of abdominal pain in women is adnexal torsion, which may occasionally involve only the fallopian tube. This condition can present with non-specific symptoms, making diagnosis challenging. Although ultrasound can reveal features suggestive of ovarian torsion, the findings are not always definitive, and other surgical emergencies such as ectopic pregnancy or appendicitis should also be considered. Early recognition and timely surgical management are essential to preserve fertility and minimize ischemic damage.

Case Presentation: The case is a 28-year-old woman, who presented with chronic pelvic pain and was diagnosed with hydrosalpinx, subsequently confirmed via laparoscopic intervention. Imaging revealed a cystic lesion near the left adnexa, initially interpreted as hydrosalpinx. During laparoscopy, the left fallopian tube was found to be twisted twice, and a salpingectomy was performed.

Conclusion: Isolated fallopian tube torsion (IFTT) is an uncommon clinical condition characterized by torsion of the fallopian tube without ovarian involvement. It may result from predisposing factors such as hydrosalpinx, pelvic inflammatory disease, or congenital anomalies. Symptoms are usually not specific, and imaging results can be uncertain. Laparoscopy remains the gold standard for both diagnosis and treatment, although laparotomy may be required in certain cases. This case highlights the importance of considering IFTT in women with unexplained chronic pelvic pain. Prompt diagnosis and surgical intervention are crucial to prevent complications and preserve reproductive potential.