Any woman who suspects she has an ectopic pregnancy should seek immediate medical attention. All of these conditions can affect the fallopian tubes directly or this area of the body.
In most cases, these conditions or procedures create scar tissue that can block the tubes. If a medical problem has affected any of these three areas, it may make getting pregnant more difficult. Each of the two ovaries is connected to the uterus by a fallopian tube. The ovaries store eggs and release them randomly, with one ovary releasing an egg each month. For example, the right ovary might release an egg for 3 months in a row, and then the left ovary might release an egg the following month.
If one fallopian tube is blocked, it may still be possible for an egg to be fertilized. If both are blocked, this is less likely. Blocked fallopian tubes can be difficult to identify. The tubes can open and close, so it is not always easy to tell if they are blocked or just closed. A laparoscopy is the most accurate test for blocked tubes.
However, doctors may not recommend this test as an early diagnosis because it is invasive and cannot treat the issue. A doctor may be able to suggest a possible diagnosis based on medical history. For example, a woman may have had a burst appendix in the past.
If the woman has had difficulty conceiving, this could suggest blocked fallopian tubes as a likely cause. It may be possible to open blocked fallopian tubes surgically. However, this depends on the extent of the scarring and where the blockage is. Whether or not a woman will be able to conceive after surgery is affected by:. If surgery is unsuccessful, a doctor may recommend in vitro fertilization IVF. IVF involves placing fertilized eggs directly into the womb, which means that the fallopian tubes are not involved in pregnancy.
Surgery to open the fallopian tubes carries the same potential complications as any surgery. These include:. One risk of pregnancy after surgery is an ectopic pregnancy, meaning that a fertilized egg gets stuck outside of the womb, often in a fallopian tube.
In acute salpingitis, the fallopian tubes become red and swollen, and secrete extra fluid so that the inner walls of the tubes often stick together. The tubes may also stick to nearby structures such as the intestines.
Sometimes, a fallopian tube may fill and bloat with pus. In rare cases, the tube ruptures and causes a dangerous infection of the abdominal cavity peritonitis. Chronic salpingitis usually follows an acute attack.
The infection is milder, longer lasting and may not produce many noticeable symptoms. In nine out of 10 cases of salpingitis, bacteria are the cause.
Some of the most common bacteria responsible for salpingitis include:. The bacteria must gain access to the woman's reproductive system for infection to take place. The bacteria can be introduced in a number of ways, including:.
This page has been produced in consultation with and approved by:. Androgen deficiency in women and its treatment is controversial, and more research is needed.
Anthrax is a rare but potentially fatal bacterial disease that occasionally infects humans. The Western obsession with cleanliness may be partly responsible for the increase in allergic asthma and conditions such as rhinitis. Careful prescribing of antibiotics will minimise the emergence of antibiotic resistant strains of bacteria.
Aspergillus is a fungus that commonly grows on rotting vegetation. It can cause asthma symptoms. Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional.
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The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website. Peer Review reports. Isolated fallopian tube torsion occurs when the fallopian tube revolves around its longitudinal axis without affecting the ovarian blood and lymphatic stream.
This is a very rare condition among the causes of acute abdominal pain in women. Its incidence has been reported as 1 in 1,, [ 1 , 2 ]. It was first described by Bland-Sutton in [ 3 , 4 ]. Despite being a very rare condition, isolated fallopian tube torsion is important in terms of creating acute abdominal pain, with surgery being the definitive method of treatment and preservation of the tube, and thus fertility, with early diagnosis and treatment being important especially in women of reproductive age.
Tubal torsion is more commonly seen on the right side. This is probably due to the fact that the mobility of the left tube is partly less than that of the right side due to its proximity to the sigmoid mesentery, and right lower quadrant pain is evaluated more frequently with surgical exploration due to suspicion of appendicitis [ 4 ].
When considering the prevalence of unilateral fallopian tube torsion, it is easily understood that bilateral torsion of the fallopian tubes is an extremely rare condition.
A review of the literature revealed that bilateral fallopian tube torsions are seen very rarely in case reports, and some of these cases are asynchronous torsions of both tubes [ 5 , 6 , 7 , 8 ]. In this case report, we describe a patient with bilateral fallopian tube torsion and bilateral hydrosalpinx who presented to our clinic with severe lower abdominal pain and was surgically treated, and we present a review of the literature.
A year-old white Arabian woman, gravida 1, parity 0, abort 1, sought medical advice in our outpatient clinic with complaints of lower abdominal pain that had started 2 days earlier.
The patient had not had any complaints of pain until 2 days earlier in her anamnesis, and she stated that her nausea had started together with the intensification of pain, but she had not vomited. She had undergone no previous abdominal operation.
Cervical movements were painful during the gynecologic examination. Laboratory test findings were as follows: white blood cell count 9. Tumor marker values were within normal limits CA , 8. A decision was made to perform emergency surgery because acute abdominal findings were apparent, with the patient describing severe pain, clinical findings progressing, and adnexal pathology being detected by US.
As preoperative diagnoses of the patient, ovarian cyst rupture and ectopic pregnancy were suspected, and fallopian tube torsion was also suspected due to the normal appearance of the ovaries and the appearance of hydrosalpinx by US.
The uterus and both ovaries were normal in abdominal observation. Hydrosalpinx was found in the right tube, and it was torsioned around itself four times and necrotic Fig.
In the left tube, hydrosalpinx and 1. The left tube was torsioned exactly at the junction of the distal hydrosalpinx and the normal proximal tubal region. There was no apparent necrotic appearance in the left tube, possibly due to the fact that circulatory disruption was not complete Fig. Bilateral salpingectomy was performed on the patient because the right tube had a prominent necrotic appearance, and there was a significant hydrosalpinx in both tubes.
The patient was discharged on the second postoperative day without any complaints and without any complications.
Histopathological examination revealed bilateral hydrosalpinx with hemorrhagic infarction findings consistent with torsion. Isolated fallopian tube torsion is a rare cause of acute abdominal pain in women. It is primarily seen in adolescent and reproductive age women and is rarely encountered in the postmenopausal period. It is also seen less frequently in the pediatric age group than in women in the reproductive period [ 1 , 4 ].
Isolated fallopian tube torsion is more common in women of reproductive age than in other age groups, probably because risk factors for tubal torsion, such as ovarian cysts, infections, and pelvic surgery, occur more frequently in women in the reproductive age group [ 9 ].
Although the etiology is not known for certain, the etiologic factors, which were divided into two groups as intrinsic and extrinsic factors, have been asserted. Intrinsic causes are factors intrinsic to tubes that contain congenital tubal abnormalities, hydrosalpinx, hematosalpinx, tubal neoplasms, and primary tubal surgeries such as tubal ligation.
Ovarian and paratubal masses, pregnancy, trauma, adhesions, and pelvic congestion are reported as extrinsic factors [ 10 ]. One of the intrinsic factors, bilateral hydrosalpinx, was present in our patient. Clinical signs of tubal torsion include lower abdominal pain, nausea, vomiting, urinary complaints, susceptible adnexal mass, and uterine bleeding. The most common symptom is pain that begins in the lower abdomen or pelvis on the affected side and may also spread to the back, thigh, or groin areas.
The properties of the pain may be continuous and ambiguous, as well as paroxysmal and knifelike. In addition, defense and rebound can be detected on the torsion side. However, none of these are specific properties [ 4 , 9 , 11 , 12 ].
Preoperative diagnosis of isolated fallopian tube torsion is difficult due to symptoms and physical examination findings not being pathognomonic and lack of specific imaging and laboratory features. Therefore, the correct diagnosis is often made during surgical intervention. Regarding the difficulty in making a preoperative diagnosis, Lo et al. Because most patients with isolated fallopian tube torsion describe lower abdominal and lateral pain, the differential diagnosis should include acute appendicitis, ovarian cyst rupture or torsion, ectopic pregnancy, pelvic inflammatory disease, endometriosis, leiomyoma degeneration, intestinal obstruction or perforation, and renal colic [ 11 , 13 ].
Although fallopian tube torsion is mostly symptomatic, cases that are asymptomatic have also been reported in the literature. For example, Murphy et al. In this regard, they stated that spontaneous bilateral fallopian tube torsion may appear as primary infertility without any symptoms beforehand; therefore, it should be considered in the differential diagnosis of patients with bilateral tubal obstruction or bilateral hydrosalpinx [ 15 ]. Although fallopian tube torsion is more common in women in the reproductive period, it should not be forgotten that it may occur in pediatric patients, though rarely.
It can often be misdiagnosed at a pediatric age. As an extremely rare case, Lima et al. The first imaging method used in most of the women with acute pelvic pain is US because of the lack of radiation exposure as well as its cost-effectiveness and noninvasiveness.
Although US features may vary in patients with tubal torsion, detection of a tapering, elongated, and curled cystic mass as it comes close to the uterine horn may suggest the diagnosis of tubal torsion.
Doppler sonography may also be helpful in the differential diagnosis. Although normal vascular flow is observed in the ovaries, a lack of diastolic flow or an observation of diastolic reverse stream together with high-impedance arterial stream in Doppler US of the adnexal mass wall may increase the suspicion of tubal torsion. However, the observation of a normal stream form by Doppler US does not always exclude the torsion [ 1 , 11 , 17 , 18 ].
Although imaging methods are generally helpful in patients with acute abdominal pain, fallopian tube torsion is rarely diagnosed preoperatively [ 13 ].
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