Department of Radiology, Beijing Youan Hospital, Capital Medical University, No. 8 Xitoutiao, Youanmen Street, Fengtai District, Beijing, 100069, China.
Department of Radiology, Linzhou People's Hospital, Linzhou, China.
BMC Pediatr. 2024 Aug 14;24(1):525. doi: 10.1186/s12887-024-05001-9.
Tubal mesosalpinx cysts are paratubal cysts, that account for approximately 10% of adnexal masses, and the presence of these cysts combined with adnexal torsion is a rare acute abdominal condition, with few cases reported in the literature. We reported two cases of adolescent tubal mesosalpinx cysts combined with adnexal torsion and reviewed the literature to help improve the diagnosis of the disease.
The first patient was an 11-year-old girl with left lower abdominal pain for 5 days and fever with nausea and vomiting for 3 days, who was found to have a cystic pelvic mass on preoperative imaging and was diagnosed intraoperatively and postoperatively on pathology as having a left tubal mesosalpinx cyst combined with adnexal torsion. The second patient was a 13-year-old girl with right lower abdominal pain for 16 h and a palpable mass in the lower and middle abdomen on examination, which was hard and tender to palpate. Preoperative imaging revealed a large cystic mass in the right adnexal region, and intraoperative and postoperative pathology revealed a right tubal mesosalpinx cyst combined with adnexal torsion.
Tubal mesosalpinx cysts combined with adnexal torsion are rare causes of acute lower abdominal pain. Early diagnosis and timely surgery are necessary to ensure ovarian and tubal function. Accurate preoperative imaging diagnosis is challenging, and MRI is a beneficial supplement to ultrasound and CT examinations, providing more objective imaging information and reducing the incidence of adverse outcomes.
输卵管系膜囊肿是输卵管旁囊肿，占附件包块的约 10%，这些囊肿合并附件扭转是一种罕见的急性腹痛情况，文献中报道的病例很少。我们报告了两例青少年输卵管系膜囊肿合并附件扭转的病例，并复习了文献，以帮助提高对该病的诊断。
第一例患者为 11 岁女孩，左下腹痛 5 天，伴发热、恶心和呕吐 3 天，术前影像学检查发现囊性盆腔肿块，术中及术后病理诊断为左侧输卵管系膜囊肿合并附件扭转。第二例患者为 13 岁女孩，右下腹痛 16 小时，检查时中下腹部可触及一肿块，质硬，有触痛。术前影像学检查显示右侧附件区有一个大的囊性肿块，术中及术后病理诊断为右侧输卵管系膜囊肿合并附件扭转。
输卵管系膜囊肿合并附件扭转是急性下腹痛的罕见原因。早期诊断和及时手术是确保卵巢和输卵管功能的必要条件。准确的术前影像学诊断具有挑战性，MRI 是超声和 CT 检查的有益补充，提供更客观的影像学信息，降低不良结局的发生率。
