Fallopian tube torsion
Last revised by Dr Avni K P Skandhan ◉ on 13 Jan 2022
Citation, DOI & article data
Citation:
Radswiki, T., Skandhan, A. Fallopian tube torsion. Reference article, Radiopaedia.org. (accessed on 18 Aug 2022) https://doi.org/10.53347/rID-14973
Permalink:
rID:
14973
Article created:
11 Sep 2011 by The Radswiki ◉
Revisions:
13 times by 6 users - see full revision history
System:
Sections:
-
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Synonyms:
- Salpinx torsion
- Tubal torsion
- Torsion of the Fallopian tube
- Isolated tubal torsion
- Isolated fallopian tubal torsion
- Isolated torsion of the Fallopian tube
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
- intrinsic factors
- pelvic inflammatory disease (PID)
- anatomical abnormalities
- hydrosalpinx
- hematosalpinx: can also be a consequence
- long mesosalpinx
- physiological abnormalities
- tubal neoplasm
- extrinsic factors
- adhesions
- adnexal venous congestion
- adjacent ovarian or paraovarian masses (e.g. paraovarian cysts)
- uterine masses
- gravid uterus
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
References
- 1. Russin LD. Hydrosalpinx and tubal torsion: a late complication of tubal ligation. Radiology. 1986;159 (1): 115-6. Radiology (abstract) - Pubmed citation
- 2. Ikeda S, Sumiyoshi M, Oki C. Torsion of the fallopian tube following sterilization. Gynecol. Obstet. Invest. 1998;46 (4): 271-3. Gynecol. Obstet. Invest. (link) - Pubmed citation
- 3. Gross M, Blumstein SL, Chow LC. Isolated fallopian tube torsion: a rare twist on a common theme. AJR Am J Roentgenol. 2005;185 (6): 1590-2. doi:10.2214/AJR.04.1646 - Pubmed citation
- 4. Ghossain MA, Buy JN, Bazot M et-al. CT in adnexal torsion with emphasis on tubal findings: correlation with US. J Comput Assist Tomogr. 18 (4): 619-25. - Pubmed citation
- 5. Propeck PA, Scanlan KA. Isolated fallopian tube torsion. AJR Am J Roentgenol. 1998;170 (4): 1112-3. AJR Am J Roentgenol (link) - Pubmed citation
- 6. Origoni M, Cavoretto P, Conti E et-al. Isolated tubal torsion in pregnancy. Eur. J. Obstet. Gynecol. Reprod. Biol. 2009;146 (2): 116-20. doi:10.1016/j.ejogrb.2009.05.002 - Pubmed citation
- 7. Vijayaraghavan SB, Senthil S. Isolated torsion of the fallopian tube: the sonographic whirlpool sign. J Ultrasound Med. 2009;28 (5): 657-62. J Ultrasound Med (full text) - Pubmed citation
- 8. Shukla R. Isolated torsion of the hydrosalpinx: a rare presentation. Br J Radiol. 2004;77 (921): 784-6. doi:10.1259/bjr/36288287 - Pubmed citation
- 9. Wong SW, Suen SH, Lao T et-al. Isolated fallopian tube torsion: a series of six cases. Acta Obstet Gynecol Scand. 2010;89 (10): 1354-6. doi:10.3109/00016349.2010.503870 - Pubmed citation
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