Adnexal Torsion After Isolated Salpingeal Torsion, an Undesired Complication of Conservative Management: A Case Report.

Isolated salpingeal torsion (IST) is a rare cause of acute abdomen in women of the reproductive age group. The lack of pathognomonic clinical, laboratory or radiographic findings makes early diagnosis a challenge. We describe a case of IST in a 13-year-old who suffered from a repeat torsion following initial conservative management. A 13-year-old girl presented with acute right lower quadrant abdominal pain of insidious onset. Her past medical history was non-contributory and her initial workup was unremarkable. Exploratory laparoscopy subsequently revealed isolated torsion of the right fallopian tube which was detorted. She presented 10 months later with similar complaints and further workup demonstrated right adnexal torsion which was confirmed by laparoscopy; salpingo-oophorectomy was necessary due to gangrenous necrosis. Conservative management of fallopian tube torsion confers the advantage of fertility preservation but the risk of repeat torsion remains clinically significant.