Fallopian tube torsion, more commonly known as twisted Fallopian tubes, is very difficult to diagnose. It causes acute pain in the lower abdomen, but has no other significant pathognomonic symptoms. There are also very limited findings from laboratory and imaging studies. Because of this, diagnosis has to rely mostly on past occurrence, history of pelvic surgeries and conditions, as well as pregnancy. To this day, early laparoscopy remains the standard in treatment and diagnosis.
The incidence of this condition is not known. Every year, only sporadic cases are documented. It almost never occurs during menopause or before menarche. The most common risk factors include ovarian infections, cysts, and surgery in the pelvic area. These statistics and frequencies support the theory that the torsion occurs mostly in females of reproductive age.
This rare gynecologic condition’s exact cause is still unknown. A number of studies, however, have posed theories and possible explanations. The torsion likely occurs with a non-intact tube, and often comes as a result of either a cyst or tumor in the ovaries. Some cases of twisted Fallopian tubes have also been reported after patients who have undergone surgical sterilization, mostly through the Pomeroy technique. Other conditions that have resulted to the torsion of the tubes include hematosalpinx, labor, fallopian tube primary carcinoma, and in premenarchal females with endometriosis.
DIAGNOSIS AND TREATMENT
Since the original Bland-Sutton description in 1890, hundreds of cases have been documented in literature. Still, the lack of symptoms, laboratory and imaging results, and clinical findings during physical examinations make the condition difficult to properly diagnose prior to surgery. If it is possible to preoperatively diagnose it, surgical intervention can be cancelled unless necessary. Laparotomy was the surgical choice of treatment and diagnosis in the past, where the pelvic area is opened up during operation to assess the condition of the tubes and the surrounding organs.