Unusual presentation of bilateral pyosalpinx mimicking an ovarian torsion: A case report

INTRODUCTION: A pyosalpinx is the acute inflammation of the Fallopian tube fills up and swells with pus, which commonly results from inadequate or delayed treatment of pelvic inflammatory disease. Herein we report a case of bilateral pyosalpinx mimicking an ovarian torsion. PRESENTATION OF CASE: We reported the case of a 27-year-old female patient, who presented to the emergency department with complaints of constant, worsening lower abdominal pain for 2–3 days. Pelvic and transvaginal ultrasound examinations were performed which demonstrated a large, complex cystic structure in the right adnexa with peripheral flow on color Doppler imaging. The possibilities included ovarian torsion or hemorrhagic cyst. Intraoperative findings showed bilateral pyosalpinx and treated successfully by laparoscopic bilateral salpingostomy. CONCLUSION: The present case highlights the diagnostic dilemma of bilateral pyosalpinx must be taken into account in the differential diagnosis of ovarian torsion or tumor, particularly in women of reproductive age.