Uncommon case of hydrosalpinx-induced adnexal torsion in a postmenopausal woman

Ahmed M. Abbas, Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt
Shymaa S. Ali, Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt
Armia Michael, Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt
Ahmed A. Mohamed, Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt

Abstract

Adnexal torsion is a twisting of the adnexa, including the ovary and/or the fallopian tube, around its own vascular axis. Most cases of adnexal torsion occur in women of reproductive age and only rarely in postmenopausal women. Here, we report a case of 58-year-old woman, postmenopausal for 6 years, who presented with acute lower abdominal pain. Ultrasound scan showed a right-sided, well-circumscribed, cystic mass measuring 50x57 mm with low level echoes. Doppler evaluation revealed no blood flow signals inside the mass. Abdominal exploration revealed right adnexal torsion. Salpingo-oophorectomy was done and histopathological examination revealed a twisted, gangrenous hydrosalpinx with no pathological lesion in the ovary. The patient was discharged on the fourth postoperative day. Although adnexal torsion in postmenopausal women is a rare event, it should not be ignored in those women who present with abdominal pain. A longer delay between admission and surgery may be attributed to the rarity and non-specific symptoms of the disease in this age group.

 

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http://ir.uiowa.edu/pog_in_press/80