2021 Volume 37 Issue 1 Pages 85-89
We report a case of fallopian tube torsion with specific imaging findings. An 11-year-old female presented with a chief complaint of lower left abdominal pain. She had experienced intermittent lower left abdominal pain for 5 days prior to presentation. An egg-sized mass was palpable in the lower left abdomen, and ultrasound revealed a tubular structure in the pelvis. A paraovarian cyst and cystadenoma were considered in the differential diagnosis. Plain magnetic resonance imaging (MRI) of the abdomen performed on the same day revealed normal ovaries but dilated luminal structures with low T1 and high T2 signals to the left of the uterus, suggesting a hydrosalpinx. Because the abdominal pain did not resolve, we reviewed the MRI, as whirlpool signs were pointed out. Torsion of the fallopian tube was strongly suspected. This was confirmed on laparoscopic surgery, and a necrotic fallopian tube was resected. Tubal torsion is a rare disease in children, and pre-operative diagnosis is difficult, often resulting in delayed treatment. Although one of the pre-operative differential diagnoses for this patient was accurate and urgent surgery was performed, the fallopian tube could not be preserved.
