Isolated Fallopian Tube Torsion

單獨輸卵管扭轉

10.6200/TCMJ.2006.3.7.10

詹景全(Chying-Chyuan Chan)；金承惠(Chen-Hui Jin)；鍾明宗(Ming-Tzeung Chung)；彭忠衎(Chung-Kan Peng)

嚴重下腹痛 ； 輸卵管扭轉 ； 輸卵管切除 ； 腹腔鏡 ； severe lower abdominal pain ； fallopian tube torsion ； salpingectomy ； laparoscopy

北市醫學雜誌

3卷7期（2006 / 07 / 01）

735 - 739

英文

下腹痛是一般急診最常見但也最難診斷的症狀，因為腹部有許多實質的器官及很多器官功能性的問題。尤其是女性病患還有週期性的生理期及懷孕必須考量。下腹痛可能只是一般的小問題也可能會是危及生命必須立即處理的症狀。臨床需要詳細的問診及小心的理學檢查，必要時亦需借重實驗室的血液、生化檢驗及超音波、腹部X光攝影、電腦斷層或核磁共振；必要時亦可能須進行腹腔鏡檢查或剖腹探查。我們報導一例十四歲小女生因下腹痛合併嘔吐經腹腔鏡診斷為輸卵管扭轉壞死的罕見病例。

Background and Purpose: Pelvic pain and/or abdominal pain are the most common complaints in a gynecological practice, and determination of the origin is often difficult. Not only are there many pathologic entities and functional disorders that cloud the diagnostic picture, but also individual responses to pain and different pain thresholds make localization of pain a diagnostic dilemma. Case report: A 14-year-old girl presented to the emergency department with the chief complaint of pelvic pain. On the day before admission, the girl experienced sudden onset of severe, right lower quadrant pain after lunch. Whole abdominal fullness, tenderness with rebound pain in the right lower quadrant was found. The pelvic ultrasound examination identified an echogenic complex mass measuring 5.4×4.1cm. Laparoscopic intervention showed a dilated, twisted, and necrotic right fallopian tube. Conclusion: Severe lower abdominal pain is difficult to diagnose sometimes. Physicians need to be more careful in the diagnosis of female patients and torsion of the fallopian tube is one of the possibilities to be considered in the differential diagnosis.