Shevach Alon Ayala, Kerner Ram, Ginath Shimon, Barda Giulia, Bar Jacob, Sagiv Ron
Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr Med Assoc J. 2019 Sep;21(9):575-579.
Isolated fallopian tube torsion (IFTT) is a rare gynecological entity and its diagnosis is challenging.
To compare clinical characteristics, sonographic findings, surgical management, and outcomes of women with surgically verified IFTT compared to those diagnosed with adnexal torsion.
A retrospective case-control study in a university hospital was conducted. Thirty-four women with surgically verified IFTT between March 1991 and June 2017 were compared to 333 women diagnosed with adnexal torsion within the same time period.
Both groups presented primarily with abdominal pain, which lasted longer prior to admission among the IFTT group (46.8 ± 39.0 vs. 30.0 ± 39.4 hours, P < 0.001). Higher rates of abdominal tenderness with or without peritoneal signs were found in the adnexal torsion group (90.3% vs. 70.6%, P < 0.001). Sonographic findings were similar; however, an increased rate of hydrosalpinx was found among the IFTT group (5.9% vs. 0.0%, P = 0.008). Suspected adnexal torsion was the main surgical indication in only 61.8% of IFTT cases compared with 79.0% in the adnexal torsion group (P = 0.02). Salpingectomy with or without cystectomy was more commonly performed in the IFTT group (35.3% vs. 1.5%, P < 0.001). The leading pathological findings among the IFTT group were hydrosalpinx and paraovarian cysts.
The clinical signs and symptoms of IFTT and adnexal torsion are similar. Although sonographic imaging demonstrating a paraovarian cyst or hydrosalpinx may be helpful in diagnosing IFTT, it is rarely done preoperatively.
孤立性输卵管扭转（IFTT）是一种罕见的妇科疾病，其诊断具有挑战性。
比较经手术证实的IFTT患者与附件扭转患者的临床特征、超声检查结果、手术治疗及预后。
在一家大学医院进行了一项回顾性病例对照研究。将1991年3月至2017年6月期间34例经手术证实的IFTT患者与同期333例诊断为附件扭转的患者进行比较。
两组主要表现均为腹痛，IFTT组入院前腹痛持续时间更长（46.8±39.0小时对30.0±39.4小时，P<0.001）。附件扭转组有或无腹膜刺激征的腹部压痛发生率更高（90.3%对70.6%，P<0.001）。超声检查结果相似；然而，IFTT组输卵管积水发生率增加（5.9%对0.0%，P=0.008）。仅61.8%的IFTT病例主要手术指征为疑似附件扭转，而附件扭转组为79.0%（P=0.02）。IFTT组更常进行输卵管切除术加或不加囊肿切除术（35.3%对1.5%，P<0.001）。IFTT组主要病理表现为输卵管积水和卵巢旁囊肿。
IFTT和附件扭转的临床体征和症状相似。尽管超声成像显示卵巢旁囊肿或输卵管积水可能有助于诊断IFTT，但术前很少能做到。
