Isolated Torsion of the Fallopian Tube: A Novel Presentation

Isolated fallopian tube torsion (IFTT) is a rare cause of acute pelvic pain that is often misdiagnosed due to its non-specific clinical findings. Early diagnosis and operative intervention are vital for the preservation of fertility. We report two cases of IFTT. The first case is of a 16-year-old female with a seven-day history of right lower abdominal pain and fevers. No flow was noted on Doppler studies of the right adnexal mass on ultrasound. Laparoscopy showed torsion of the fallopian tube, and a salpingectomy was performed. The second case was in a 42-year-old woman with a two-day history of lower abdominal pain, nausea, and vomiting. Radiology revealed a right fallopian tube cystic mass with decreased perfusion. Histopathology of the specimen showed ischemic changes, and a laparoscopic salpingectomy was performed. The postoperative course of both patients was uneventful. IFTT is a rare but clinically significant differential diagnosis of acute pelvic pain. A high index of suspicion, early imaging, and laparoscopic definitive management aid in optimizing outcomes and preserving fertility in these patients.