July 10th, 2020

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Diagnosis and Management of Isolated Tubal Torsion: Is Salpingectomy Mandatory?
Authors:  Mustafa Gazi Uçar, M.D., Mehmet Çelik, M.D., Fatih Sanlikan, M.D., Tolgay Tuyan Ilhan, M.D., Ahmet Göçmen, M.D., and Çetin Çelik, M.D.
  OBJECTIVE: To review the clinical characteristics of patients with isolated fallopian tube torsion (IFTT).

STUDY DESIGN: We conducted a retrospective study of a consecutive series of IFTT cases presenting at 2 tertiary referral centers. All patients underwent laparoscopic assessment, and the fallopian tube and its ligamentous support were gently untwisted to assess ischemic lesions. Patients were classified based on the following 3 criteria: complete recovery (Group A), partial recovery (Group B), and without any recovery (Group C).

RESULTS: Our series consisted of 9 patients. Group A (2 cases) and Group B (5 cases) were managed conservatively. Two patients were assigned to group C and underwent laparoscopic salpingectomy. During early postoperative period, in the conservatively managed group 4 patients underwent hysterosalpingography examination, and both fallopian tubes were found to be patent. One of these 4 patients had a spontaneous pregnancy and delivered a healthy infant, and another patient had a miscarriage at 6 weeks’ gestation. Imaging revealed no pathological findings in the remaining 3 virgins in the conservatively managed group. No infections, peritonitis, thromboembolic events, or other complications occurred during the follow-up period.

CONCLUSION: Conservative management of IFTT can be considered a safe option, even if little evidence of recovery is observed after detorsion.
Keywords:  abdominal pain, fallopian tube, fallopian tube diseases, isolated tubal torsion, laparoscopy, salpingectomy, conservative therapy, torsion abnormality
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