Case report of an un-usually large hematosalpinx

Hematosalpinx is the accumulation of blood in fallopian tubes. Its most common cause is ectopic pregnancy, but the other causes include pelvic inflammatory disease (PID), endometriosis and pelvic trauma. We report a rare case of hematosalpinx in a 45-year-old female with no obvious cause. She presented with acute sharp right iliac fossa pain not relieving with analgesics. She did not have a history of fever, PID, endometriosis, or trauma. Her menstrual cycle was also normal and β-hcG was negative. Ultrasound showed the right ovarian cyst and was suggesting of hemorrhagic. She was operated and a large hematosalpinx was observed. This rare case suggests the possibility of Hematosalpinx in the mid-40s besides ruling out the possibility of some of the causes hypothesized in the relevant literature. The case highlights the need to better understand the pathophysiology of hematosalpinx.