Tubal torsion with parafimbrial cyst

Case contributed by Dr Alexandra Stanislavsky

Presentation

Acute onset right iliac fossa pain

Patient Data

Age: 30 years
Gender: Female
Ultrasound

Normal size, anteverted uterus without myometrial or endometrial anormality.

Both ovaries are normal in size and appearance. Both are mobile and non-tender and ovarian vascularity was demonstrated bilaterally. 

However in the right adnexal region, there is a thickened tubular structure which is twisted, giving a "whirlpool" appearance - highly suspicious for tubal torsion. Adjacent to this (and clearly separate from the right ovary), there is an anechoic structure measuring 3.4 x 7.0 x 3.8 cm which lies in close proximity to the medial uterine tube on the right. 
There is a small amount of free fluid with low level echoes in this region. 
The appendix is normal. 

Case Discussion

At surgery, tubal torsion was confirmed. There was an associated parafimbrial cyst, which likely acted as a lead point for torsion. The right ovary was confirmed to be normal.

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Case information

rID: 68830
Published: 16th Jun 2019
Last edited: 14th Aug 2019
System: Breast
Inclusion in quiz mode: Included

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