Isolated torsion of the distal part of the fallopian tube in a premenarcheal 12 year old girl: a case report.

Isolated torsion of the fallopian tube in premenarcheal girls is very rare. However, correct diagnosis and treatment are needed in order to optimize salvage of fallopian tube. Here, we report a case of fallopian tube torsion in a premenarcheal girl. A 12-year-old premenarcheal girl was admitted with a rapid history of colicky lower abdominal pain. MR image demonstrated normal ovaries and a large spherical cystic tumor with hemorrhage-like contents. The differential diagnosis included torsion of a para-ovarian cyst or hydrosalpinx, hemorrhage within a non-communicating uterine horn or a pelvic hemorrhage of unknown origin. Laparoscopic inspection/operation was performed. The distal portion of the left fallopian tube was swollen with two twists evident in the middle portion. The distal portion of the left fallopian tube was laparoscopically removed with the aid of a YAG laser. The mechanisms underlying disorders of the left fallopian tube are not well understood. However, some intrinsic/extrinsic causative factors are discussed. Although torsion of the fallopian tube occurs rarely and exhibits variable clinical features, the diagnosis should be considered in all young girls presenting with sudden colicky abdominal pain. Laparoscopic inspection/surgery appears to be the most suitable management.