Role of laparoscopy in the management of isolated falloppian tube torsion in adolescents

Background/Purpose Isolated Fallopian tube torsion (IFTT) is a rare cause of acute abdominal pain in female. The preoperative diagnosis is difficult because of a lack of specific clinical and radiological signs. Surgery is often performed when is no longer possible to preserve the integrity of the tube. We report our experience in the laparoscopic management of four teenagers with IFTT. Methods Four patients (aged 12 to 15 years) came to our observation for worsening abdominal pain, nausea and vomit. On admission all girls had blood tests, ultrasound and Magnetic Resonance. Laparoscopy was performed in all cases for the diagnosis. All girls had US and clinic follow up. Results Laparoscopic exploration allowed the diagnosis of IFTT with necrosis of the same in all cases. In two girls a laparoscopic salpingectomy was performed. In the other two cases an open salpingectomy was necessary because of pelvic adhesions. Histology showed a hemorrhagic infarction of the Fallopian tubes. At follow up all patients were asymptomatic with normal ovaries. Conclusions In the differential diagnosis of acute abdominal pain in children or female adolescents the possibility of IFTT should always be considered, since an early diagnosis can lead to a conservative treatment. Laparoscopy allows to perform a definitive diagnosis and treatment.