Laparoscopic tubal salvage in an adolescent girl with bilateral isolated tubal torsion

Abstract

Purpose of investigation: To report surgical treatment of a rare case of bilateral isolated fallopian tube torsion (IFTT). IFTT, especially when occurring bilaterally in adolescents, poses the dilemma of whether removing the salpinges, preventing the possibility of spontaneous conception, or restoring tubal patency, risking IFTT recurrence or a future ectopic pregnancy. Case Report: A 13-year-old, sexually inactive, presented after being discharged with the diagnosis of bilateral tubal ectasia from another hospital, where she received antibiotic treatment. At laparoscopy, bilateral IFTT was diagnosed. One tube was necrotic and a salpingectomy was performed. The contralateral tube presented a hydrosalpinx, but, once derotated and drained, appeared viable and salpingoneostomy and salpingopexy were performed. Six-month follow up was uneventful. Conclusion: in cases with an uncertain diagnosis, especially in young women in which tubal preservation is particularly important, laparoscopy allows an early diagnosis of tubal torsion and a conservative treatment before irreversible tubal necrosis occur.