Abstract
INTRODUCTION: Isolated fallopian tube torsion (IFTT) is an exceedingly rare but serious cause of acute abdominal pain, especially in pediatric patients, with a reported prevalence of 1 in 1.5 million women. It occurs when the fallopian tube twists around its own axis, leading to venous and lymphatic obstruction, ischemia, and potential necrosis, without involving the ipsilateral ovary. This case report highlights the presentation, diagnosis, and management of IFTT in a 14-year-old girl. CASE PRESENTATION: A 14-year-old girl presented with severe right-sided lower abdominal pain and vomiting. Physical examination revealed right iliac fossa tenderness. Imaging, including ultrasonography and magnetic resonance imaging, showed a large right hydrosalpinx. Diagnostic laparoscopy confirmed the presence of isolated fallopian tube torsion with ischemic changes necessitating a right salpingectomy. The postoperative course was uneventful, and she remains well at follow-up. CLINICAL DISCUSSION: IFTT is rare in children and often confused with appendicitis due to similar symptoms. Diagnosis requires high suspicion and imaging, with ultrasound being the primary modality. Surgical exploration is essential for diagnosis and treatment, with salpingectomy necessary in cases of severe ischemia. In pediatric patients, conservative management with tubal detorsion must be considered in less severe cases. CONCLUSION: FTT is a rare but serious condition that can mimic more common abdominal issues. Early recognition and prompt surgical intervention are crucial, particularly in the pediatric population, where concerns about future fertility are more significant. While salpingectomy was performed in this case, further research should focus on assessing the potential benefits of tubal detorsion and revascularization on future fertility outcomes.