A Case of Adolescent-Onset Fallopian Tube Torsion Whose Definitive Diagnosis Took a Long Time

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  • Nishida Nanako
    Department of Pediatric Surgery, Research Fields in Medical and Health Sciences, Medical and Dental Areas, Research and Education Assembly, Kagoshima University
  • Harumatsu Toshio
    Department of Pediatric Surgery, Research Fields in Medical and Health Sciences, Medical and Dental Areas, Research and Education Assembly, Kagoshima University
  • Kawano Takafumi
    Department of Pediatric Surgery, Research Fields in Medical and Health Sciences, Medical and Dental Areas, Research and Education Assembly, Kagoshima University
  • Kedoin Chihiro
    Department of Pediatric Surgery, Research Fields in Medical and Health Sciences, Medical and Dental Areas, Research and Education Assembly, Kagoshima University
  • Nagano Ayaka
    Department of Pediatric Surgery, Research Fields in Medical and Health Sciences, Medical and Dental Areas, Research and Education Assembly, Kagoshima University
  • Matsui Mayu
    Department of Pediatric Surgery, Research Fields in Medical and Health Sciences, Medical and Dental Areas, Research and Education Assembly, Kagoshima University
  • Sugita Koshiro
    Department of Pediatric Surgery, Research Fields in Medical and Health Sciences, Medical and Dental Areas, Research and Education Assembly, Kagoshima University
  • Onishi Shun
    Department of Pediatric Surgery, Research Fields in Medical and Health Sciences, Medical and Dental Areas, Research and Education Assembly, Kagoshima University
  • Muto Mitsuru
    Department of Pediatric Surgery, Research Fields in Medical and Health Sciences, Medical and Dental Areas, Research and Education Assembly, Kagoshima University
  • Ieiri Satoshi
    Department of Pediatric Surgery, Research Fields in Medical and Health Sciences, Medical and Dental Areas, Research and Education Assembly, Kagoshima University

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Other Title
  • 発症から診断までに時間を要した思春期発症卵管捻転の1例
  • ハッショウ カラ シンダン マデ ニ ジカン オ ヨウシタ シシュンキ ハッショウランカン ネンテン ノ 1レイ

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Abstract

<p>Fallopian tube torsion with an adolescent onset is rare, and the lack of specific findings hampers a preoperative diagnosis. We experienced treating a case of fallopian tube torsion at puberty whose definitive diagnosis took a long time. [Case] A 13-year-old girl presented to the emergency clinic with a chief complaint of left lower abdominal pain that had begun one week before this visit. She was diagnosed with acute enteritis and kept under observation. However, she continued to have abdominal pain, and her pediatrician suspected that she had appendicitis with an abscess. Despite treatment with antimicrobial agents, her symptoms did not improve, so she was referred to our department with a suspicion of acute abdomen. Enhanced computed tomography (CT) showed a 4-cm cystic lesion in the pelvic cavity. Diagnostic laparoscopy was performed under suspicion of ovarian torsion or adnexal torsion. A dark-red twisted left fallopian tube was seen on the dorsal side of the uterus. Untwisting the tube laparoscopically proved difficult, so laparotomy of the lower abdomen was performed. The fallopian tube had a torsion of 1,440°, and it remained dark red even after the torsion had been released. Her left ovary was normal. Preservation of the fallopian tubes was impossible, and tubectomy was performed. [Conclusion] Many cases of tubal torsion are difficult to diagnose and ultimately result in tubal resection. An early diagnosis is important for preserving the fallopian tubes.</p>

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