Fallopian tube torsion

Last revised by Dr Jeremy Jones on 20 Sep 2021

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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Cases and figures

  • Case 1
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  • Case 2
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  • Case 3: with ovarian torsion- paratubal cyst
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  • Case 4: tubo-ovarian torsion
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