tubal torsion

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A Fallopian tube torsion is a type of adnexal torsion and usually occurs in association with an ovarian torsion (when it is then termed a tubo-ovarian torsion). An isolated fallopian tube torsion is rare but can occur.

Pathology

An isolated tubal torsion can occur as a late complication of tubal ligation .

Other risk factors for an isolated fallopian tube torsion include

intrinsic factors
- pelvic inflammatory disease (PID)
- anatomical abnormalities
  - hydrosalpinx
  - hematosalpinx: can also be a consequence
  - long mesosalpinx
- physiological abnormalities
  - tubal spasm
  - hypermotility of tube
- tubal neoplasm
extrinsic factors
- adhesions
- adnexal venous congestion
- adjacent ovarian or paraovarian masses (e.g. paraovarian cysts)
- uterine masses
- gravid uterus

Location

There is a well-recognized right-sided predilection

Radiographic features

Ultrasound

Reported sonographic findings include

a normal-appearing uterus and ovaries with normal flow
free fluid
a dilated tube with thickened, echogenic walls and internal debris
a convoluted echogenic mass thought to represent a thickened, torsed tube
sonographic whirlpool sign: described as a relatively specific sign of tubal torsion

CT

Reported primary CT findings of isolated tubal torsion include

an adnexal mass
twisted appearance to the fallopian tube with dilated tube greater than 15 mm
thickened and enhancing tubal wall and luminal CT attenuation greater than 50 HU, compatible with hemorrhage

Secondary signs include