Isolated Fallopian Tube Torsion in a Premenarchal Female Patient: A Case Report

TL;DR

A 12-year-old girl experienced isolated fallopian tube torsion, a rare condition that caused acute abdominal pain and was confirmed through surgery.

Contribution

This case highlights the importance of considering IFTT in adolescents with pelvic pain and normal-appearing ovaries on imaging.

Findings

IFTT was diagnosed in a premenarchal girl with left lower abdominal pain and vomiting.

MRI findings suggested adnexal torsion, confirmed by laparoscopy showing a 540-degree fallopian tube torsion.

The ovary was unaffected, emphasizing the need for early surgical intervention to preserve fertility.

Abstract

Isolated fallopian tube torsion (IFTT) is a rare cause of acute pelvic pain, especially in pediatric patients. It is often misdiagnosed due to non-specific clinical and imaging findings. We report a 12-year-old girl who presented with acute onset of left lower abdominal pain and vomiting. Laboratory investigations, including tumor markers, were normal. Imaging studies (ultrasound and magnetic resonance imaging (MRI)) demonstrated a normal-appearing ovary with an adjacent heterogeneous adnexal mass. However, MRI findings raised suspicion for adnexal torsion. Emergency laparoscopy confirmed a 540-degree torsion of the left fallopian tube secondary to a paratubal cyst. The ovary was unaffected and appeared grossly normal. IFTT should be considered in adolescent females with pelvic pain and normal-appearing ovaries on imaging. Early surgical intervention is crucial for preserving fertility and preventing complications.

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