IFTT in children and adolescents—single-center experience and systematic review of literature
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In brief
In brief
This systematic review of isolated fallopian tube torsion in pediatric patients found that early diagnosis and laparoscopic intervention are critical for preserving reproductive potential. Analysis of 170 cases showed that symptom duration beyond 24 hours significantly increased salpingectomy rates, emphasizing the importance of prompt surgical exploration when IFTT is suspected in adolescent girls with acute abdominal pain.
- IFTT is rarely diagnosed preoperatively (only 16.4% of cases), leading to delayed recognition in adolescent girls with acute abdominal pain.
- Symptom duration >24 hours significantly increases salpingectomy rate; early laparoscopy is critical to preserve reproductive potential.
- Organ-sparing detorsion is feasible in 33% of cases when blood supply is restored, challenging the default salpingectomy approach.
- Left fallopian tube is slightly more affected (53%), with pain present in 99% and nausea in 57% of pediatric IFTT cases.
- Emergency laparoscopy should be performed when IFTT is suspected to enable timely detorsion and address concomitant pathology.
Written by the GCMD Library team from the article.
Abstract
Purpose
Isolated fallopian tube torsion (IFTT) is defined by rotation of the fallopian tube around itself without involving the ipsilateral ovary. It is a rare cause of acute lower abdominal pain in (adolescent) girls, but is commonly overlooked. Due to its rarity, literature is still scarce. Currently there is no generally accepted management and treatment.
Methods
A retrospective analysis of all IFTT cases treated in our institution was performed. In addition, a systematic literature research on pediatric IFTT was carried out on Medline/ PubMed database according to PRISMA principles using predefined search terms and inclusion criteria. Patient characteristics regarding age, clinical symptoms, diagnostic methods, treatment, and follow-up were analyzed.
Results
Three of our patients and fifty-nine reports totaling one hundred seventy girls were included in the analysis. Mean age was 13.0 years. Left tube was slightly more often affected (52.9%). Abdominal pain was present in 99.4% of cases accompanied with nausea in 57.1%. In only 16.4%, correct preoperative diagnosis was made. Salpingectomy was the most common treatment in 111 (66.9%) cases, 55 (33.1%) patients were treated with detorsion of the tube (organ-sparing management). Girls with symptoms longer than 1 day had a significant higher rate of salpingectomy (95% CI, P = 0.0323).
Conclusion
When IFTT is suspected, emergency laparoscopy should be performed to possibly preserve future reproductive potential. In case of detorsion and reinstated blood supply, organ-preserving management should be performed with simultaneous addressment of concomitant pathology if possible. Sufficient long-term follow-up must be assured to get significant results to introduce guidelines for children and adolescents.