Isolated Fallopian Tube Torsion in Pediatric and Adolescent Females: A Retrospective Review of 15 cases at a Single Institution

• Published in: Journal of pediatric & adolescent gynecology Vol. 26; no. 3; pp. 189 - 192
• Main Authors: Casey, Rachel K., MD, Damle, Lauren F., MD, Gomez-Lobo, Veronica, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2013
• Subjects: Abdominal Pain - etiology; Adnexal torsion; Adolescent; Child; Fallopian Tube Diseases - complications; Fallopian Tube Diseases - diagnostic imaging; Fallopian Tube Diseases - surgery; Fallopian tube torsion; Female; Humans; Obstetrics and Gynecology; Ovarian Cysts - diagnostic imaging; Pediatrics; Retrospective Studies; Salpingectomy; Torsion Abnormality - complications; Torsion Abnormality - diagnostic imaging; Torsion Abnormality - surgery; Tubal torsion; Ultrasonography; Tubal torsion; Adnexal torsion; Fallopian tube torsion
• ISSN: 1083-3188; 1873-4332
• DOI: 10.1016/j.jpag.2013.02.010

Abstract Study Objective To identify and review cases of isolated fallopian tube torsion (FTT) at our institution to further characterize diagnosis and management. Design Retrospective review. Setting Tertiary care medical center. Participants Case series of pediatric and adolescent females, <21 years old, with operatively diagnosed isolated fallopian tube torsion from our institution. Intervention None. Main Outcome Measure Isolated fallopian tube torsion. Results Fifteen cases of isolated fallopian tube torsion were identified based on intraoperative diagnosis. Patient ages ranged from 8-15 years old, mean age of 12. Fourteen patients (93%) presented with abdominal pain, 8 (53%) localized to the side of associated torsion. Ultrasonography reports described a tubular structure in 4 patients and an associated ovarian or paraovarian cyst in eleven patients. Suspicion of fallopian tube torsion was only described for those patients with a tubular structure described on ultrasonography report. Intraoperatively, 7 patients (47%) were found to have no associated pathology and 8 (53%) were found to have associated cyst or hydrosalpinx. Eight (53%) patients underwent salipingectomy and 7 (47%) underwent reversal of torsion with drainage of associated cyst or cystectomy. Conclusions Isolated fallopian tube torsion is a rare condition that seems to occur in younger adolescents. Vague clinical presentation contributes to low preoperative suspicion. Preoperative suspicion may be increased based on radiographic findings of an enlarged tubular structure or an adjacent normal ovary. Management may be considered nonemergent and salpingectomy is controversial. Long-term fertility outcomes must be further assessed for more definitive decisions regarding surgical management.