Torsion of fallopian tube with gangrenous ovary and early pregnancy: A rare case report

Torsion of the fallopian tube during early pregnancy is a very rare phenomenon. Most of them present with acute abdominal pain and are often misdiagnosed with a twisted ovarian cyst, ectopic pregnancy, appendicitis, etc. A 19-year-old female was referred to the medical department for pain abdomen, nausea, and vomiting. Her last menstrual period was 28 days back. The urine pregnancy test was negative. Ultrasonogram (USG) was suggestive of encapsulated exophytic hemorrhagic cyst in the right adnexa arising from the right ovary. A huge right-twisted fimbrial cyst with hemorrhagic contents (14 cm × 12 cm) along with a gangrenous right ovary was evident in emergency laparotomy. Right salpingo-oophorectomy was performed. She was discharged with an uneventful postoperative recovery. She presented again after 2 months with postoperative amenorrhea, nausea, and vomiting. USG suggested 12 weeks of pregnancy, which continued until term. Eventually, a lower segment cesarean section was done for fetal distress. A twisted fallopian tube during pregnancy is a rare phenomenon. A high index of suspicion necessitates prompt diagnosis and prevention of future fertility and obstetric morbidity.