Hydrosalpinx with adnexal torsion in an adult patient–A case report

Adnexal torsion is a common gynecological emergency and a significant cause of acute pelvic pain in women. Hydrosalpinx-induced torsion of the adnexa is a rare situation and requires prompt and accurate management. Twenty-three years old nulliparous woman admitted in our structure for acute pelvic pain. The ultrasound revealed an enlarged right ovary with an adnexal cystic mass. We suspected the diagnosis of a right adnexal torsion due to cystic ovarian mass. Laparotomy revealed torsion of the right adnexa and a second large mass appearing to be a hydrosalpinx. Diagnosis of adnexal torsion is difficult and is based on a range of arguments obtained by anamnesis, clinical examination, ultrasonography and other investigations. Early diagnosis is important for preserving tubal and ovarian function, given the risk of ovarian necrosis in young women. Laparoscopy is the gold standard for diagnosing and treating adnexal torsion. The treatment can be conservative or radical, consisting of detorsion of the twisted adnexa, with or without adnexectomy.