Ovary

Other nonneoplastic

Torsion



Topic Completed: 1 September 2013

Minor changes: 19 October 2020

Copyright: 2002-2021, PathologyOutlines.com, Inc.

PubMed Search: Fallopian tubes torsion [title]

Nicole Riddle, M.D.
Shahid Islam, M.D., Ph.D.
Page views in 2020: 1,654
Page views in 2021 to date: 3,718
Cite this page: Riddle N, Shutter J., Islam S. Torsion. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarytubetorsion.html. Accessed October 20th, 2021.
Definition / general
Ovary:
  • Rare; partial or complete rotation of ovarian vascular pedicle, causing obstruction to venous outflow and arterial inflow
  • In children, ovary is often normal (Arch Pediatr Adolesc Med 2005;159:532)

Fallopian tube:
  • "Twisting" of fallopian tube that blocks blood flow, causing ischemia and associated edema and pain
  • Often accompanies torsion of adjacent ovary (often with a cyst) but may be isolated to tube
Epidemiology
Fallopian tube:
  • Occurs in women of all ages
  • 2/3 involve right tube
Etiology
Fallopian tube:
  • Usually associated with a mass / cyst causing rotation / obstruction
  • Also PID, hydrosalpinx, tubal ligation or adhesions
  • Occasionally no identifiable cause
Clinical features
    Ovary:
    • Presents with abdominal pain, patients need emergency ultrasound and laparoscopy (J Pediatr Adolesc Gynecol 2008;21:201)
    • Predisposing factors: large cyst, neoplasms (benign or malignant), pelvic inflammatory disease; also associated with in vitro fertilization

    Fallopian tube:
  • sharp lower abdominal pain, fever, tachycardia, leukocytosis (Acta Obstet Gynecol Scand 2010;89:1354)
Radiology description
  • Fallopian tube: ultrasound usually shows adnexal mass with heterogeneous echogenicity and cystic component with fluid levels
Case reports
Treatment
Ovary:
Fallopian tube:
  • May resolve or tube may become necrotic and calcified with autoamputation of tube and ovary
  • Often requires surgical excision
Clinical images

Images hosted on other servers:

Fallopian tube

Gross description
  • Fallopian tube: swollen, dusky fallopian tube, with or without associated mass / cyst
Gross images

AFIP images

Hemorrhagic infarction of tube



Images hosted on other servers:

Ovarian torsion

Due to large serous cystadenoma

Microscopic (histologic) description
  • Fallopian tube: ischemic necrosis of mucosa and wall
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