Laparoscopic salvage of fallopian tube herniation following cesarean section drain removal: a case report

Abstract

Fallopian tube herniation through a surgical drain site is an exceptionally rare postoperative complication. Most historically reported cases have been managed via open relaparotomy and frequently necessitated partial or complete salpingectomy due to tissue ischemia or incarceration. We report a rare case of post-cesarean fallopian tube herniation that was successfully managed via timely laparoscopic reduction, resulting in the complete preservation of tubal viability and future fertility. A 20-year-old primigravida with severe preeclampsia and thrombocytopenia underwent an emergency lower-segment cesarean section for fetal distress. Intraoperatively, diffuse oozing from the operative field prompted the insertion of a pelvic drain. Following drain removal on postoperative day three, a tubular structure was noted protruding through the drain site. Clinical presentation was highly suggestive of fallopian tube prolapse. Diagnostic laparoscopy confirmed the herniation of a congested but viable left fallopian tube through the drain tract, accompanied by adjacent omental traction. The tube was successfully reduced laparoscopically without the need for a relaparotomy or salpingectomy. The patient recovered uneventfully and remained asymptomatic at her follow-up appointments. Fallopian tube herniation through a drain site is a rare, potentially fertility-threatening complication. Early clinical recognition coupled with prompt laparoscopic intervention facilitates the assessment and preservation of tubal viability, circumvents the morbidity of an open relaparotomy, and optimizes patient outcomes.