关键词: 孤立性输卵管扭转, 输卵管积水, 输卵管系膜囊肿, 诊断, 治疗

Abstract:

Objective: To investigate the clinical characteristics of isolated fallopian tube torsion (IFTT). Methods: The clinical data of 27 IFTT patients, admitted to Peking University Third Hospital during January 2017 to December 2021, were retrospectively analyzed. Results: ①Clinical characteristics: 22 women of childbearing age, and 7 women experienced the onset of IFTT during pregnancy. Twenty-four patients presented with abdominal pain as the primary symptom, and 3 patients were diagnosed IFTT during surgery.②Examination, surgery and pathology: All patients underwent preoperative ultrasound examination, suggested tortuosity or cystic anechogenicity in the adnexal area. More specifically, 21 patients were operated laparoscopic surgery, while 6 patients underwent laparotomy. The choice of whether to preserve the fallopian tube depends on patient′s fertility requirements and where the torsion site. Of the 16 patients who had given birth, 2 cases of mesosalpinx cyst torsion preserved fallopian tubes, and the rest of them underwent salpingectomy. In the 11 cases who did not give birth, salpingectomy was performed in 3 patients of hydrosalpinx who scheduled to undergo assisted reproductive technology assisted pregnancy, and the rest of them were preserved fallopian tubes. The pathological findings were consistent with preoperative ultrasonography, suggesting hydrosalpinx or benign cysts in the fallopian tubes. ③There were seven IFTT patients during pregnancy, two were diagnosed during the second trimester pregnancy and five in the third trimester pregnancy. One patient was operated laparoscopic surgery, while the other six underwent laparotomy. However, all seven patients presented mesosalpinx cyst torsion. Three patients were treated with mesothelial cystectomy, with the fallopian tube retained, while four patients were treated with salpingectomy. All neonates showed good outcome. Conclusions: If women of childbearing age with hydrosalpinx and mesosalpinx cysts report sudden abdominal pain, the possibility of IFTT should be considered. Early diagnosis and treatment can avoid fallopian tube torsion and necrosis to preserve the patient′s ability to conceive naturally. The decision to keep the fallopian tube should be determined according to the patient′s fertility requirements and the site and degree of fallopian tube torsion.

Key words: Isolation fallopian tube torsion, Hydrosalpinx, Mesosalpinx cysts, Diagnosis, Therapy