Isolated tubal torsion in an adolescent girl: A sometimes difficult, but critical diagnosis

Isolated tubal torsion is a rare condition in the pediatric population; it is usually not immediately diagnosed. We describe the case of a 12 year-old girl admitted to the emergency department for left abdominal pain. Ultrasound showed suspicion of adnexal cysts. After a few hours, the patient complained of acute abdominal pain. An exploratory laparoscopy revealed a left isolated fallopian tube torsion. Given the necrotic aspect of the adnexa and the absence of vascularisation after salpingeal detorsion, a decision of salpingectomy was made. There are no specific symptoms for isolated tubal torsion. Different investigations may be envisaged,but laparoscopy typically confirms the diagnosis. Unfortunately, salpingectomy follows in most cases. The differential diagnosis of abdominal pain in female patients must include tubal torsion as a delayed diagnosis may impair tube salvation and lead to salpingectomy.