Isolated 720-Degree Tubal Torsion Associated With Tubal Ectopic Pregnancy: A Case Report and Review of Previously Reported Cases

Isolated tubal torsion (ITT) is uncommon, particularly in ectopic pregnancy. The coexistence of these conditions presents a significant diagnostic challenge and requires prompt surgical intervention. Only four cases of ITT secondary to ectopic pregnancy have been reported in the English-language literature. A 25-year-old woman (G4P2) with a history of a recent cesarean section complicated by pelvic infection presented with acute left lower abdominal pain and six weeks of amenorrhea. A clinical examination revealed left adnexal tenderness. Transvaginal ultrasonography demonstrated an 8 cm heterogeneous adnexal mass and a serum β-hCG level of 4,990 mIU/mL. Emergency laparoscopy identified an ectopic pregnancy involving approximately two-thirds of the left fallopian tube, which had undergone torsion of 720 degrees. Laparoscopic left salpingectomy was successfully performed. The patient’s postoperative course was uneventful, with a rapid decline in β-hCG levels. This case highlights the importance of considering ITT in pregnant women presenting with acute pelvic pain and adnexal masses, particularly in the presence of prior pelvic inflammatory or surgical pathology.