Torsioned Hydrosalpinx After Surgical Sterilization: Report of an Unusual Case

Abstract

Adnexal torsion is an uncommon gynecologic emergency that requires a high index of suspicion to prevent loss of the affected adnexa and preserve its function. Isolated torsion of the fallopian tube is mainly associated with hydrosalpinx and a history of tubal sterilization; it usually presents with sudden, nonspecific abdominal pain, which may mislead the examiner toward more common causes of acute abdomen and makes preoperative diagnosis difficult. The aim of this report is to describe a case of post–salpingoligation hydrosalpinx torsion, a rare etiology of acute abdomen. We present the case of a 46-year-old woman with a history of bilateral salpingoligation and myomectomy, who presented with a few hours’ evolution of severe abdominal pain associated with vasovagal symptoms. Transvaginal ultrasonography revealed a left adnexal cystic mass, initially suggestive of torsion of an ovarian cyst. Surgical exploration confirmed torsion of a left hydrosalpinx with a normal-appearing ovary. Detorsion and salpingectomy were performed, with a favorable postoperative course and subsequent hospital discharge. This case highlights the need for a high index of suspicion in female patients presenting with acute abdomen and underscores the importance of considering this condition in the differential diagnosis. Dissemination of such cases contributes to the international literature on this topic and reinforces the value of thorough history-taking, physical examination, and appropriate complementary studies to achieve an accurate diagnosis.