Isolated Fallopian Tube Torsion: An Underdiagnosed Entity with Debatable Management.

Area of Science:

• Gynecologic Surgery
• Reproductive Medicine
• Diagnostic Imaging

Background:

• Isolated fallopian tube torsion (IFTT) is a rare gynecologic emergency.
• Early diagnosis and appropriate management are crucial for preserving tubal function.
• Distinguishing IFTT from other adnexal pathologies can be challenging.

Purpose of the Study:

• To identify key features aiding in the early diagnosis of IFTT.
• To describe current management strategies for IFTT.
• To compare IFTT with adnexal torsion.

Main Methods:

• Retrospective cohort study (October 2017-October 2020) at a tertiary care hospital.
• Inclusion of patients with surgically confirmed adnexal torsion or IFTT.
• Data collection included gynecological examination, imaging, and laparoscopy.

Main Results:

• Nine cases of IFTT were identified among 64 torsion cases.
• IFTT patients were younger and more frequently presented with fever.
• Ultrasound findings of isolated hydrosalpinx and surgical observation of para-ovarian cysts were specific to IFTT.

Conclusions:

• IFTT may be underdiagnosed due to subtle clinical and imaging findings.
• Hydrosalpinx and para-ovarian cysts should increase suspicion for IFTT.
• Tubal detorsion appears to be a viable management option, warranting further long-term follow-up studies on tubal patency.