John Preeti R, Pasley Amelia M
Baltimore VA Medical Center, 10 North Greene Street, 5C-119, Baltimore, MD 21201, USA; Department of Surgery, University of Maryland Medical Center, Baltimore, MD, USA.
University of Maryland Medical Center, Baltimore, MD, USA.
Case Rep Surg. 2016;2016:5424092. doi: 10.1155/2016/5424092. Epub 2016 Dec 14.
Isolated torsion of the Fallopian tube is an uncommon cause of acute lower abdominal pain and can occur in women of all age groups. Cholecystitis is a frequent cause of upper abdominal pain. We present an unusual case with the presence of these two distinct pathological entities occurring concurrently in the same patient, causing simultaneously occurring symptoms. To our knowledge, this is the first reported presentation of such a case. We describe a 34-year-old premenopausal woman who presented with right sided upper and lower abdominal pain and nausea. Abdominal ultrasound (US) revealed acute cholecystitis. Vaginal US was suggestive of right hydrosalpinx. Intravenous antibiotics were administered and consent was obtained for operative intervention. During laparoscopy, the right Fallopian tube with hydrosalpinx was noted to be twisted three times. The right ovary appeared normal. The gall bladder wall was thickened and inflamed. Laparoscopic right salpingectomy and cholecystectomy were performed. Surgical pathology revealed hydrosalpinx with torsion and acute calculous cholecystitis. The patient had an uneventful postoperative course and was discharged home on the first postoperative day. Her symptoms resolved after the procedure. In women with abdominal pain, both gynecologic and nongynecologic etiologies should be considered in the differential diagnoses. Concurrent presence of symptomatic gynecologic and nongynecologic intra-abdominal pathology is rare. Isolated Fallopian tube torsion is rare and is associated most often with hydrosalpinx. Some torqued Fallopian tubes can be salvaged. Laparoscopy is useful in management of both Fallopian tube torsion and cholecystitis.
孤立性输卵管扭转是急性下腹痛的罕见原因，可发生于所有年龄组的女性。胆囊炎是上腹痛的常见原因。我们报告了一例罕见病例，同一患者同时出现这两种不同的病理情况，并同时引发症状。据我们所知，这是首例此类病例的报道。我们描述了一名34岁的绝经前女性，她出现了右上腹和下腹部疼痛以及恶心症状。腹部超声检查显示为急性胆囊炎。经阴道超声提示右侧输卵管积水。给予静脉抗生素治疗，并获得了手术干预的同意。在腹腔镜检查过程中，发现右侧积水的输卵管扭转了三次。右侧卵巢外观正常。胆囊壁增厚且发炎。进行了腹腔镜下右侧输卵管切除术和胆囊切除术。手术病理显示为扭转的输卵管积水和急性结石性胆囊炎。患者术后恢复顺利，术后第一天出院。术后症状缓解。对于腹痛女性，鉴别诊断时应考虑妇科和非妇科病因。有症状的妇科和非妇科腹腔内病理情况同时存在较为罕见。孤立性输卵管扭转罕见，最常与输卵管积水相关。一些扭转的输卵管可以挽救。腹腔镜检查对输卵管扭转和胆囊炎的治疗均有用。
