Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
Volume 10 No. 4 Oktober 2022

Management of Isolated Tubal Torsion (ALADIN) during Emergency Laparotomy in Infertile Women

Bella Aprilia (Department of Obstetrics and Gynecology, Faculty of Medicine University of Indonesia, Jakarta)
Raymond Surya (Unknown)
Bram Pradipta (epartment of Obstetrics and Gynecology, Urban Hospital Koja, Jakarta)



Article Info

Publish Date
30 Oct 2022

Abstract

Introduction: Isolated tubal torsion (ITT) is rare cases with challenging to diagnose. We would like to report ITT and primary infertility patient which came with acute abdominal pain. Case: A 36 yo female came to Koja Hospital with acute abdominal pain without sign of infections. Ultrasound findings show cystic mass on bilateral adnexal sized 76x28x39 mm and 31x51x43 mm with minimal ascites. During laparotomy, proximal right fallopian tube was torsioned four times clockwise. There was hydrosalping founded on contralateral tube, while right and left ovaries and uterus were normal. We performed salpingectomy. Discussion: The clinical presentation of ITT is non-specific and it has become a challenge to physician to develop preoperative diagnosis. The spectrum of imaging findings may be wide range depending on adnexal pathology, degree of severity, and the duration of adnexal torsion. The recommendation of primary approach to tubal torsion is conservative management considering ALADIN (mALignAncy-Death tissue, INfertility). Conclusion: The diagnosis is rarely be made before operation, due to non-specific clinical symptoms and imaging findings. The considerations to perform conservative management are malignancy, death tissue/necrotic, and infertility.

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Journal Info

Abbrev

journal

Publisher

Subject

Health Professions Medicine & Pharmacology Public Health

Description

The Indonesian Journal of Obstetrics and Gynecology is an official publication of the Indonesian Society of Obstetrics and Gynekology. INAJOG is published ...