Isolated Paratubal Cyst Torsion during Pregnancy: A Case Report

Among the obstetric and gynecologic emergencies are paratubal or paraovarian cysts, which are generally detected in pregnancy, incidentally. Isolated torsion of a paratubal cyst, especially in late pregnancy, is extremely rare. Here, a case of isolated paratubal cyst torsion during pregnancy is introduced.

The patient was a 36-years-old woman with gestational age of 35 weeks of second pregnancy referred to the department of obstetrics due to severe crampy abdominal pain as well as nausea and vomiting. Ultrasound assessment revealed a 7×8 cm adnexal cyst. Regarding worsening of the patient's pain, despite the report of normal ovarian vascular flow, laparotomy was performed due to suspicion of ovarian torsion. An isolated paratubal cyst torsion was confirmed during laparotomy.

Nonspecific clinical features and uncommon objective findings are the main causes of misdiagnosis of ovarian torsion in pregnancy. Regarding the large uterus in pregnancy, the diagnosis of torsion is challenging. Therefore, there should be a high index of suspicion for firm diagnosis and appropriate management.