A Gurbanova, K Bahadır, E Evin, U Ateş, G Göllü, T Aktuğ
Ankara University, School of Medicine, Department of Pediatric Surgery
PURPOSE: Isolated tubal torsion is a rare cause of acute abdomen in pediatric age group and is a differential diagnosis among the causes of acute abdomen during puberty. Preoperatively, it can be confused with ovarian torsion in the clinical and radiological diagnosis stage. We aimed to present the surgical details and postoperative follow-up of laparoscopic isolated tubal detorsion.
CASE: A 16-year-old female patient was admitted to our clinic with abdominal pain which started 1 day ago. Her mensturation periods was regular. Physical examination revealed sensitivity and rebound in the right lower quadrant of abdomen. Acute phase reactants were found to be normal in the patient's blood tests and no pathology was detected on the abdominal X-ray. Abdominal ultrasonography has shown that appendix was normal , but there was a cyst in the right ovary and also there was no blood circulation in the right ovary. In the urgent laparoscopic operation, a 4x5 cm cyst near the distal part of tuba and tubal 360 degree torsion were observed. Laparoscopic detorsion was performed for the tube and the cyst in the tube was aspirated and sent to cytology and the patient was discharged on the following postoperative day. Cytology was consistent with hemorrhagic and degenerated cyst fluid which did not suggest malignancy. There was no ovarian or tubal pathology in the control ultrasonography in the first postoperative month.
CONCLUSION: : It should be kept in mind that isolated tubal torsion may cause acute abdomen for girls in reproductive ages. The advantages of the laparoscopic approach are; safety, also providing a safe evaluation of the whole abdomen during surgery and shortening of hospital stay.