Isolated tubal ischemia secondary to small bowel volvulus: a rare case report

Authors

  • Marouane Boukroute Department of Obstetrics and Gynecology, Mohammed VI University Hospital Center, Oujda, Morocco
  • Abdelmajide Regragui Department of Obstetrics and Gynecology, Mohammed VI University Hospital Center, Oujda, Morocco
  • Zaineb Chatbi Department of Obstetrics and Gynecology, Mohammed VI University Hospital Center, Oujda, Morocco
  • Ibtissam Bellajdel Department of Obstetrics and Gynecology, Mohammed VI University Hospital Center, Oujda, Morocco
  • Hafsa Taheri Department of Obstetrics and Gynecology, Mohammed VI University Hospital Center, Oujda, Morocco
  • Hanane Saadi Department of Obstetrics and Gynecology, Mohammed VI University Hospital Center, Oujda, Morocco
  • Ahmed Mimouni Department of Obstetrics and Gynecology, Mohammed VI University Hospital Center, Oujda, Morocco

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20251992

Keywords:

Fallopian tube ischemia, Secondary tubal torsion, Small bowel volvulus, Post-appendectomy adhesions, Gynecologic emergency, Acute abdomen in women

Abstract

Torsion of the fallopian tube is a rare cause of acute abdominal pain, often underrecognized in the context of intestinal pathology. We reported the case of a 30-year-old woman who developed isolated fallopian tube ischemia secondary to small bowel volvulus, a complication rarely described. She presented with acute hypogastric pain, vomiting, and mild left hydronephrosis. CT imaging revealed a small bowel obstruction with a whirlpool sign but no apparent tubal abnormalities. Laparotomy identified a twisted, ischemic fallopian tube with hydrosalpinx, attributed to adhesions from a recent appendectomy. Salpingectomy, small bowel resection, and anastomosis were performed, with histopathology confirming ischemic necrosis. This case underscores the diagnostic challenge posed by overlapping gastrointestinal and gynecological emergencies and suggests that vascular compromise in small bowel volvulus may extend to pelvic structures. Given the rarity of secondary tubal torsion, clinicians should consider this possibility in women with prior pelvic surgery and acute abdominal pain. Early CT imaging and interdisciplinary collaboration are essential for timely intervention and improved outcomes.

Metrics

Metrics Loading ...

References

Hibbard LT. Adnexal torsion. Am J Obstet Gynecol. 1985;152(4):456-61. DOI: https://doi.org/10.1016/S0002-9378(85)80157-5

Oelsner G, Shashar D. Adnexal torsion. Clin Obstet Gynecol. 2006;49(3):459-63. DOI: https://doi.org/10.1097/00003081-200609000-00006

Ten Broek RP, Issa Y, van Santbrink EJ, Bouvy ND, Kruitwagen RFPM, Jeekel J, et al. Burden of adhesions in abdominal and pelvic surgery: systematic review and meta-analysis. BMJ. 2013;347:5588. DOI: https://doi.org/10.1136/bmj.f5588

Chang HC, Bhatt S, Dogra VS. Pearls and pitfalls in diagnosis of ovarian torsion. Radiographics. 2008;28(5):1355-68. DOI: https://doi.org/10.1148/rg.285075130

Roggo A, Ottinger LW. Acute small bowel volvulus in adults is a sporadic form of strangulating intestinal obstruction. Ann Surg. 1992;216(2):135-41. DOI: https://doi.org/10.1097/00000658-199208000-00003

Iwuagwu O, Deans GT. Small bowel volvulus: a review. J R Coll Surg Edinb. 1999;44(3):150-5.

Welch CE. Intestinal obstruction. Chicago: Year Book Publishers; 1958: 14.

Burke MS, Glick PL. Gastrointestinal malrotation with volvulus in an adult. Am J Surg. 2008;195(4):501-3. DOI: https://doi.org/10.1016/j.amjsurg.2006.09.036

Welch GH, Anderson JR. Volvulus of the small intestine in adults. World J Surg. 1986;10(3):496-9. DOI: https://doi.org/10.1007/BF01655319

Ellis H. Acute intestinal obstruction. In: Schwartz SI, Ellis H, eds. Maingot’s Abdominal Operations. 9th Ed. Vol 1. Norwalk, CT: Appleton & Lange; 1989: 855-904.

Guzzetta PC, Anderson KD, Altman RP. Paediatric Surgery. In: Schwartz SI, Shires GT, Spencer FC, eds. Principles of Surgery. Vol 2. New York: McGraw-Hill; 1989: 1688-728.

Wiersma R, Hadley GP. Small bowel volvulus complicating intestinal ascariasis in children. Br J Surg. 1988;75:86-7. DOI: https://doi.org/10.1002/bjs.1800750130

Qayyum A, Cowling MG, Adam EJ. Small bowel volvulus related to a calcified mesenteric lymph node. Clin Radiol. 2000;55(6):483-5. DOI: https://doi.org/10.1053/crad.2000.0092

Bernstein SM, Russ PD. Midgut volvulus: a rare cause of acute abdomen in an adult patient. Am J Roentgenol. 1998;171(3):639-41. DOI: https://doi.org/10.2214/ajr.171.3.9725289

Islam S, Hosein D, Dan D, Naraynsingh V. Volvulus of ileum: a rare cause of small bowel obstruction. BMJ Case Rep. 2016:2016216159. DOI: https://doi.org/10.1136/bcr-2016-216159

El-Feky M, Dixon A. Ovarian torsion. In Radiopaedia. 2010. DOI: https://doi.org/10.53347/rID-9540

Ali AM, Mohamed AN, Omar AA, Mohamed YG. Laparoscopic management of ischemic right fallopian tube torsion mimicking perforated appendicitis. Int J Surg Case Rep. 2022;93:106914. DOI: https://doi.org/10.1016/j.ijscr.2022.106914

Downloads

Published

2025-06-26

How to Cite

Boukroute, M., Regragui, A., Chatbi, Z., Bellajdel, I., Taheri, H., Saadi, H., & Mimouni, A. (2025). Isolated tubal ischemia secondary to small bowel volvulus: a rare case report. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 14(7), 2362–2365. https://doi.org/10.18203/2320-1770.ijrcog20251992

Issue

Section

Case Reports