Lo Liang-Ming, Chang Shuenn-Dhy, Lee Chyi-Long, Liang Ching-Chung
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Chang Gung University College of Medicine, Taoyuan, Taiwan.
Aust N Z J Obstet Gynaecol. 2011 Jun;51(3):244-7. doi: 10.1111/j.1479-828X.2011.01288.x. Epub 2011 Feb 7.
The diagnosis of adnexal torsion can be difficult to make, especially in isolated fallopian tube torsion (FTT). Only small series and several case reports on isolated FTT have been published in the literature.
To demonstrate symptom presentations, objective findings and surgical outcomes in women with isolated FTT over a 12-year period at a tertiary hospital.
Using the International Classification of Disease, Ninth Revision, and Clinical Modification, we reviewed the clinical records of women with isolated FTT during 1996 and 2008 at our institute.
Seventeen women, age 13-50 (mean 32) with surgically proven isolated FTT, were included. Five women (29.4%) had tubal ligation history. None of these cases were diagnosed before operation. Pain characteristics were variable; the onset was sudden in 10 (58.8%) and 17 (100%) complained of lower abdominal pain, but only six (35.3%) had peritoneal signs. Other clinical manifestations were as follows: nausea or vomiting in seven women (41.2%), lower urinary tract symptoms in four (23.5%) and fever in three (17.6%). All the women had a cystic adnexal mass on ultrasound. An enlarged tubal mass (5-14 cm) was found in all the cases at surgery. Eleven women (64.7%) underwent laparoscopy, and six (35.3%) laparotomy for salpingectomy.
The diagnosis of isolated FTT is often not made before surgical intervention because clinical features are non-specific. However, it needs to be considered in women with acute lower abdominal pain with a unilateral cystic adnexal mass.
附件扭转的诊断可能具有挑战性，尤其是在孤立性输卵管扭转（FTT）的情况下。文献中仅发表了关于孤立性FTT的少量系列研究和几例病例报告。
展示一家三级医院12年间孤立性FTT女性患者的症状表现、客观检查结果及手术结局。
我们使用国际疾病分类第九版临床修订本，回顾了1996年至2008年我院孤立性FTT女性患者的临床记录。
纳入17例年龄在13 - 50岁（平均32岁）经手术证实为孤立性FTT的女性患者。5例（29.4%）有输卵管结扎史。这些病例术前均未确诊。疼痛特征各异；10例（58.8%）起病突然，17例（100%）均主诉下腹痛，但仅有6例（35.3%）有腹膜刺激征。其他临床表现如下：7例（41.2%）恶心或呕吐，4例（23.5%）下尿路症状，3例（17.6%）发热。所有女性患者超声检查均发现附件区囊性包块。手术中所有病例均发现输卵管肿大（5 - 14厘米）。11例（64.7%）接受了腹腔镜检查，6例（35.3%）接受剖腹手术并行输卵管切除术。
由于临床特征不具特异性，孤立性FTT常在手术干预前未被诊断出来。然而，对于急性下腹痛且伴有单侧附件区囊性包块的女性，需考虑该病。
