Hematosalpinx

Fig.1: Sagittal US image of the pelvis of a 13-year-old girl presenting with acute pelvic pain shows multiple cystic lesions (arrows) behind the uterus (U). These cystic structures have peculiar frondlike structures internally suggesting that they represent a dilated fallopian tube.
Fig. 2: Sagittal T2W MR image confirms the presence of dilated fallopian tube with fluid-fluid levels, suggesting hematosalpinx.

Facts: What Causes Hematosalpinx?

• Tubal pregnancy (most common)
• Endometriosis
• Fallopian tube cancer
• Obstructed vagina resulting in menstrual blood backflow into fallopian tubes

Facts: Isolated Tubal Torsion

• Very rare entity causing lower abdominal pain
• Usually occurs in reproductive age
• Diagnosis rarely made preoperatively
• Imaging findings are adnexal cystic mass, hydrosalpinx, hematosalpinx
• Twisted fallopian tube, if visualized, is a specific sign for tubal torsion. If the ovary is also torsed, the ipsilateral ovary becomes enlarged.

Our case: isolated fallopian tube torsion causing hematosalpinx.

Reference:

1. Park BK, Kim CK, Kim B. Isolated tubal torsion: specific signs on preoperative computed tomography and magnetic resonance imaging. Acta Radiologica 2008;49:233-235.

2. Wikipedia: hematosalpinx