Hydrosalpinx leading to fallopian tube torsion in a 10-year-old female: A case report

Isolated fallopian tube torsion (IFTT) is a rare complication in the pediatric population, especially among the pre-adolescent and pre-menarcheal population. A10-year-old prepubertal girl with no past surgical history and a history of autoimmune hepatitis, ADHD, hyperlipidemia and constipation presented with a 4-day history of sharp abdominal pain. Initially the pain was localized to the suprapubic region, but it later became diffuse. She was hemodynamically stable, and all laboratory values were unremarkable. An initial ultrasound showed preserved vascular flow to non-enlarged ovaries. Computerized tomography of the abdomen and pelvis with contrast demonstrated an indeterminate fluid structure in the right lower quadrant. A follow-up ultrasound showed right hydrosalpinx measuring 5.1 x 5.7 × 5.6 cm with free fluid adjacent to the right ovary. Magnetic resonance imaging re-demonstrated a tubular structure in the right lower quadrant adjacent to the right ovary with preserved ovaries. The patient underwent diagnostic laparoscopy, which confirmed isolated right fallopian tube torsion with ischemic changes. The Fallopian tube was detorsed and regained proper vascularization. The fluid within the Fallopian tube was evacuated. The right ovary was intact. She recovered well from the operation and was discharged home shortly thereafter. One week after the operation she was free of symptoms. Fallopian tube torsion should be included in the differential diagnosis of pre-adolescent and pre-menarcheal females with abdominal pain.