Višnjić Stjepan, Kralj Rok, Zupančić Božidar
Pediatric Surgery Department, Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia.
J Med Case Rep. 2014 Jun 17;8:197. doi: 10.1186/1752-1947-8-197.
Isolated fallopian tube torsion as a complication of a preexisting hydrosalpinx is a rare finding in pediatric patients. The obvious rarity of this condition, its subtle diagnostic features and dissonant previous reporting about the appropriate therapeutic approach according to age, future conception capacity and potential complications of possible pregnancies make the decision about which surgical approach to use very difficult. In this report, we describe the case of a patient with such a presentation and review the literature. Very few similar reports of neosalpingostomy in pediatric patients have been published to date.
In our present report, we describe the case of an 11-year-old Caucasian prepubertal girl who presented to our hospital with complaints of abdominal pain in the right lower quadrant, nausea and vomiting. The diagnostic workup led us to conclude that she had a torsion of the right ovary, which was cystically altered. Exploratory surgery revealed a partial hydrosalpinx and consecutive isolated torsion of the fimbrial part. The proximal isthmic part of the fallopian tube was intact and vital. Restorative surgery was performed to create a neosalpingostomy on the viable isthmic part of the tube and remove the cystic and twisted fimbrial and infundibular parts.
The surgical procedure described in this report is technically simple and feasible, but leaves doubts about the final outcome.
孤立性输卵管扭转作为既往存在的输卵管积水的一种并发症，在儿科患者中是一种罕见的发现。这种情况明显罕见，其诊断特征不明显，且此前关于根据年龄、未来受孕能力以及可能妊娠的潜在并发症选择合适治疗方法的报道存在分歧，这使得决定采用何种手术方法非常困难。在本报告中，我们描述了一例有此类表现的患者病例并对文献进行综述。迄今为止，儿科患者中关于输卵管造口术的类似报道极少。
在我们目前的报告中，我们描述了一名11岁的白种人青春期前女孩的病例，她因右下腹痛、恶心和呕吐前来我院就诊。诊断检查使我们得出结论，她右侧卵巢扭转，且卵巢呈囊性改变。探查手术发现部分输卵管积水以及连续的伞端孤立性扭转。输卵管近端峡部完整且有活力。进行了修复手术，在输卵管有活力的峡部创建了一个新的输卵管造口，并切除了囊性和扭转的伞端及漏斗部。
本报告中描述的手术操作在技术上简单可行，但对最终结果仍存在疑问。
