Fallopian tube torsion

Last revised by Dalia Ibrahim on 12 Aug 2023

A fallopian tube torsion is a type of adnexal torsion and usually occurs in association with an ovarian torsion (when it is then termed a tubo-ovarian torsion). An isolated fallopian tube torsion is rare but can occur. 

Pathology

An isolated tubal torsion can occur as a late complication of tubal ligation 1,2.

Other risk factors for an isolated fallopian tube torsion include 3,8 

Location

There is a well-recognized right-sided predilection 9

Radiographic features

Ultrasound

Reported sonographic findings include 3,5

  • a normal-appearing uterus and ovaries with normal flow

  • free fluid

  • a dilated tube with thickened, echogenic walls and internal debris 

  • a convoluted echogenic mass thought to represent a thickened, torsed tube

  • sonographic whirlpool sign: described as a relatively specific sign of tubal torsion 7

CT

Reported primary CT findings of isolated tubal torsion include 3,4

  • an adnexal mass

  • twisted appearance to the fallopian tube with dilated tube greater than 15 mm

  • thickened and enhancing tubal wall and luminal CT attenuation greater than 50 HU, compatible with hemorrhage

Secondary signs include

  • free intrapelvic fluid

  • peritubular fat stranding

  • enhancement and thickening of the broad ligament

  • regional ileus

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