Isolated torsion of the hydrosalpinx in a postmenopausal woman

Abstract

Objectives: Isolated torsion of the fallopian tube is an uncommon cause of acute lower abdominal pain. It is often found in reproductive-age women and is found less in prepubertal and perimenopausal women.

Methods: We describe a 70-year-old postmenopausal woman who presented with lower abdominal pain and discomfort. Ultrasonography revealed a well-defined, echo-free cystic mass measuring 5.3 cm x 5.8 cm without septations. Laparoscopic examination showed a dark-red, round-shaped cystic lesion that twisted at the right infundibulo-pelvic ligament site in the right adnexa area with adhesion to the posterior uterine surface and separation from the atrophic ovary.

Results: The pathology study of the excised tumor showed hydrosalpinx with torsion. The patient was asymptomatic after the procedure. Torsion of the hydrosalpinx is rare in postmenopausal women. In postmenopausal women presenting with low abdominal pain with an adnexal mass, the gynecologist should contemplate possible torsion of the hydrosalpinx.

Conclusion: The case was unusual in the postmenopausal age group, making it a rare presentation of a rare entity. Laparoscopy could be a useful tool in diagnosing and treating isolated tubal torsion.

Figure 1.

(a) Transvaginal ultrasound showed an echo-free cystic lesion, 5.3 cm × 5.8 cm without septations, located in the right adnexal area. (b) Laparoscopic examination revealed a dark-red, round-shaped cystic lesion that twisted at the infundibulo-pelvic ligament site with adhesion to the right posterior surface of uterus.