Purpose or Case Report: Isolated bilateral fallopian tube cyst torsion is extremely rare in the pediatric population. We have found no published reports of this entity in a child. Early diagnosis of such cases is crucial for the possibility of fallopian tube salvage surgery and the prevention of irreversible damage. Nonspecific clinical and imaging findings in a few reported unilateral cases in children often make surgical intervention mandatory for the diagnosis.

A 10-year-old girl came to the hospital for acute lower abdominal pain. Ultrasound findings demonstrated two large para-ovarian cysts, contiguous with tortuous and dilated fallopian tubes, suggesting torsion of the tubes. A clinician ordered CT did not add any new information.
The patient underwent a diagnostic laparoscopy that confirms the USG impression of the torsion of the bilateral fallopian tubes. Surgical exploration demonstrated twisting of about 1080 degrees of the hemorrhagic and necrotic right paratubal cyst and tube. The left cyst and tube were torsed at 360 degrees. Right partial salpingectomy, left paratubal cyst aspiration, and detorsion of fallopian tubes was accomplished. The uterus and ovaries were healthy.

Isolated bilateral fallopian tube torsion is extremely rare in the pediatric population with nonspecific clinical and imaging findings. Diagnosis usually requires surgery. Our study showed a case of bilateral fallopian tube torsion that occurred about bilateral paratubal cysts. Visualization of a dilated fallopian tube in the presence of normal-sized ovaries must be concerning for fallopian tube torsion, which can be secondary to a paratubal mass or cyst. Prompt early recognition and operative management of this relatively rare entity may prevent unnecessary tubal resection and improve long term fertility.
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