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Case Reports
. 2024 Oct 22;11(3):e2024.00025.
doi: 10.4293/CRSLS.2024.00025. eCollection 2024 Jul-Sep.

Spontaneous Autoamputation of Adnexa

Mariam S Banoub  1 , Elena M Konrath  1 , Burhan A Khan  1   2 , Rayan A Elkattah  1
Affiliations
Case Reports

Spontaneous Autoamputation of Adnexa

Mariam S Banoub et al. CRSLS. .

Abstract

Introduction: Acquired ovarian torsion is an uncommon gynecologic emergency that afflicts women of reproductive age and requires correction by surgery. A rare complication of asymptomatic ovarian torsion can be necrosis and autoamputation of the adnexal structures.

Case description: A 28-year-old nulliparous woman presented with irregular menses since puberty associated with dysmenorrhea, menorrhagia, and nausea, and that did not improve with trials of oral hormone therapy. Ultrasound and pelvic MRI revealed a large, tubular-cystic mass separated from the right ovary and tubo-ovarian junction. Intraoperative findings revealed filmy adhesions and fimbriae emanating from this cystic lesion, as well as dilation of the medial portion of the right fallopian tube. Histopathology reported dilated, cystic structures with focal tubal-type epithelial lining, and a dilated fallopian tube lumen, consistent with hydrosalpinx.

Discussion: Autoamputation of fallopian tube is a rare but serious complication of adnexal torsion that should be treated promptly via intraoperative detorsion.

Keywords: Adnexal torsion; Autoamputation; Ovarian torsion.

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Conflict of interest statement

Conflict of interests: none.

Figures

Figure 1.
Figure 1.
Pelvic MRI T2-weighted images display normal appearing uterus (label A), a normal appearing left ovary (label D), and a large tubular cystic mass measuring 9.8 × 8.8 × 8.6-cm axial view (label C). A 5.9-mm separation of the right ovary and tubal ovarian junction is visible (label B).
Figure 2.
Figure 2.
Intraoperative laparoscopic view reveals a normal appearing uterus with normal appearing left fallopian tube and ovary. A large dilated right fallopian tube is noted (arrow). No fimbriae are present on the dilated tube.
Figure 3.
Figure 3.
A dilated lateral right fallopian tube is noted on label A. A normal appearing right ovary is visualized just medial to it. A large tubular-cystic structure with thin adhesions is identified in the posterior cul-de-sac, medial to the right ovary (label B). Although not shown on this image, fimbriae were identified along the posterior and caudal surface of this cystic structure.
See this image and copyright information in PMC

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