Milki A, Jacobson D H
Department of Gynecology and Obstetrics, Stanford Health Services, CA 94305, USA.
J Reprod Med. 1998 Sep;43(9):836-8.
While torsion of the adnexa is relatively common, isolated torsion of the fallopian tube alone remains a rare occurrence. Diagnosis and surgical intervention are often delayed.
A 38-year-old woman presented with acute lower right abdominal pain initially managed as renal colic. She returned to the emergency department three days later. After surgical consultation, a computed tomography scan and ultrasound showed a cystic pelvic mass with normal ovarian flow studies. Ultimately, the gynecology team performed laparoscopy with the suspicion of intermittent adnexal torsion. A 6 x 8-cm, twisted, dusky purple right fallopian tube was noted. A laparoscopic salpingectomy was performed.
In the differential diagnosis of acute lower abdominal pain, isolated torsion of the fallopian tube should be considered. A timely diagnosis and surgical intervention may allow preservation of the tube. Even when irreversible damage has occurred, laparoscopic management is recommended.
虽然附件扭转相对常见,但单纯输卵管扭转仍较为罕见。诊断和手术干预往往会延迟。
一名38岁女性因右下腹部急性疼痛就诊,最初被诊断为肾绞痛。三天后她返回急诊科。经外科会诊后,计算机断层扫描和超声检查显示盆腔有一个囊性肿块,卵巢血流检查正常。最终,妇科团队因怀疑间歇性附件扭转而进行了腹腔镜检查。发现右侧输卵管扭曲,呈暗紫色,大小为6×8厘米。遂进行了腹腔镜输卵管切除术。
在急性下腹痛的鉴别诊断中,应考虑单纯输卵管扭转。及时诊断和手术干预可能有助于保留输卵管。即使发生了不可逆的损伤,也建议采用腹腔镜治疗。