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Fallopian tube torsion

Dr Matt A. Morgan ◉ and Radswiki et al.

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 spasm
  - hypermotility of tube
- tubal neoplasm
extrinsic factors
- adhesions
- adnexal venous congestion
- adjacent ovarian or paraovarian masses (e.g. paraovarian cysts)
- uterine masses
- gravid uterus

Location

There is 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 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 units, compatible with hemorrhage

Secondary signs include

free intrapelvic fluid
peritubular fat stranding
enhancement and thickening of the broad ligament,
regional ileus

References

Ultrasound - gynaecology

Article information

rID: 14973

System: Gynaecology

Tag: cases, gynaecology, fallopian tube, ultrasound

Synonyms or Alternate Spellings:

Tubal torsion
Torsion of the Fallopian tube
Isolated tubal torsion
Isolated fallopian tubal torsion
Isolated torsion of the Fallopian tube

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