Multiple bilateral paratubal cysts and recurrent bilateral fallopian tube torsion in a premenarchal female: A case report

Paratubal cysts are rare cystic structures that are usually asymptomatic; rarely, they may cause torsion of the adnexa. We report the case of a 13-year-old premenarchal female who presented with left lower quadrant abdominal pain for 4 days. She had a history of a previous right fallopian tube cyst and torsion 9 months prior, treated at an outside hospital with diagnostic laparoscopy, right tubal detorsion, and paratubal cystectomy. Abdominal ultrasound demonstrated a right-sided para-ovarian fluid filled structure. She underwent diagnostic laparoscopy, which demonstrated bilateral 5 cm paratubal cysts attached to the fimbriae of both fallopian tubes, with bilateral fallopian tube torsion. Both ovaries and fallopian tubes had good blood flow. Both fallopian tubes also had findings of multiple small cysts budding from the tubular mesothelium. Bilateral detorsion was performed. The large cysts were excised, and the multiple small cysts were drained. We preserved both fallopian tubes and most of the fimbriae. Pathology resulted in benign paratubal cysts. Adnexal torsion due to paratubal cysts can occur in the premenarchal pediatric population, affect both fallopian tubes, and recur. This case report aims to highlight unusual cause of adnexal torsion and its potential harm if not diagnosed in a timely manner.