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A medical condition called hematosalpinx causes an accumulation of blood within the fallopian tube. It is usually seen in patients with ectopic pregnancy. Inflammatory disease of the pelvis, tubal cancer, pelvic trauma, and endometriosis are further causes. Here, we report a unique case of hematosalpinx with associated tubal torsion in a 13-year-old female lacking any previously reported contributing causes. She is celibate and presented with abdominal pain and fever. Beta-hcg was not present, and her menstrual cycle was regular. Pelvic ultrasound sonography revealed a large cyst and was suggestive of a right paraovarian cyst. An exploratory laparotomy was performed and a giant hematosalpinx was observed in an otherwise normal ovary. In conclusion, although very rare in adolescence, hematosalpinx must be considered in the differential diagnosis. This unusual instance highlights new concerns regarding the pathogenesis of hematosalpinx.

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We report four cases of isolated fallopian tube torsion (IFTT) successfully treated with laparoscopic surgery over the past 10 years. Two young women (each 19 years old) were IFTT with paraovarian cyst (POC) and tubal preservation was possible with detorsion and cystectomy. The other two patients (a 41-year-old woman with hydrosalpinx and a 50-year-old woman with hematosalpinx) underwent salpingectomy and adnexectomy, respectively, because there was no desire for tubal preservation. One patient had emergency surgery due to severe abdominal pain, one had semi-emergency surgery due to mild abdominal pain, and the other two were diagnosed during scheduled surgery without symptoms.Although IFTT was considered a very rare disease, our case series and recent reports suggest that it may have been underestimated, as it accounts for approximately 10% of adnexal torsion cases. Preoperative diagnosis of IFTT may be more difficult than for adnexal torsion because of its infrequency and nonspecific, vague clinical symptoms.　Since the prevalent age for this disease is young, as in our first 2 patients, early surgical intervention to preserve the fallopian tubes should be chosen when necessary, and it seems to be important for gynecologists to be aware of this disease for earlier diagnosis and appropriate surgical intervention.

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PURPOSE: Paraovarian cysts in children and adolescents can be challenging to accurately diagnose prior to surgery. Our objective is to outline the clinical characteristics of paraovarian cysts and enhance the precision of diagnosing paraovarian cysts in this age group. METHODS: We retrospectively analyzed all patients with paraovarian cysts who underwent surgery in our department from 2013 to 2021. The review focused on demographic characteristics, clinical manifestations, intraoperative findings, and postoperative pathology of these patients. RESULTS: This cohort was composed of 38 children with paraovarian cysts. The average diameter of the cysts was 4.8 cm (range 0.5-10 cm). Among the cases, 25 (65.8%) had adnexal torsion. Postoperative pathology showed that all cases were simple cysts with serous fluid. After the procedure, the patients were monitored for a period ranging from 12 to 108 months. B-ultrasound and physical examination did not reveal any significant abnormalities. CONCLUSIONS: B-ultrasound can help diagnose paraovarian cysts by detecting slight deviation movement between the cyst and the uterus. The presence of adnexa torsion in children and adolescents with paraovarian cysts does not depend on BMI, but rather on the size of cysts. Laparoscopic cyst removal has proven to be an effective surgical approach with favorable outcomes.

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Introduction: A paraovarian cyst (POC) is a cyst in the broad ligament or mesosalpinx. Paraovarian cysts have an estimated prevalence of 5-20% amongst the adnexal masses. Despite the high prevalence and availability of advanced imaging modalities, an accurate pre-operative diagnosis of POC is still made in less than 50% of patients. Case reports: Two females with suspected ovarian torsion underwent laparotomy and had POCs. A 42-year-old hysterectomized female underwent surgery for a suspected POC which turned out to be a mesenteric cyst. Two females underwent laparotomy for suspected mesenteric cysts which turned out to be POCs. A nulliparous female with infertility conceived spontaneously after cystectomy of POC. Results: Optimal management of an adnexal mass depends on the knowledge of the origin and the exact nature of the mass. No clear-cut guidelines exist for the management of POCs despite their high prevalence. There is a need for further research on this topic to formulate clear-cut guidelines for their management. Conclusions: Radiologists and gynaecologists need to keep them in mind as differentials for patients with adnexal masses to ensure a correct pre-operative diagnosis in order to achieve an optimal outcome for these females. Gynaecologists need to be aware of the cases which can be managed conservatively and those that need surgery, along with the extent of the surgery required, taking care to protect the ovary at all costs, particularly in benign cases.

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Fimbrial cysts also known as paraovarian cysts are small and asymptomatic and are occasionally large resulting in pelvic pain. It is difficult to differentiate a fimbrial cyst from an ovarian cyst by imaging; therefore, they are often recognized intra-operatively during laparotomy. This report presents a rare case of a 48-year-old female who presented with the primary complaints of persistent right lower abdominal pain that was intermittently radiating to the back for one year. Clinical findings reported the possibility of twisted right hydrosalpinx but the tumor biomarkers were found to be within the normal range. In addition to this, ultrasound sonography (USG) and magnetic resonance imaging (MRI) revealed a pelvic mass that was indicative of cystic lesions. As the above-mentioned diagnosis was found to be challenging, exploratory laparotomy as a part of surgical intervention and diagnosis was performed along with histopathological investigations that confirmed the existence of fimbrial end cysts on both sides. Fimbrial end cysts represent a rare yet significant cause of abdominal pain; therefore, early recognition, thorough clinical evaluation, and appropriate diagnostic workup are essential for timely intervention and preventing potential complications associated with fimbrial end cysts.

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Introduction: Paraovarian or paratubal cysts both define cysts located between the ovary and the fallopian tube. They are usually benign and frequently occur in the third and fourth decade of life. Paratubal cysts are defined as giant when they exceed the threshold of 150 mm. Methods: We report the case of a 15-year-old girl who complained about diffuse abdominal pain since 2 years that was diagnosed with a 196 mm × 90 mm × 267 mm giant paratubal cyst. We furthermore reviewed all the data published on 13 articles, published between 2006 and 2021, concerning giant paraovarian cyst (POC) in pediatric patients. Results: The giant mass of our 15-year-old patient was removed through a fertility-sparing laparoscopic surgery. Histopathological diagnosis of cystadenofibroma was made up, with no cytologic report of neoplastic cells. The incidence of POC in the pediatric and adolescent population attests around 4%. However, only 12.96% of them are defined giant (larger than 15 cm). Indeed, to the best of our knowledge, only 13 cases of giant paratubal cysts have been reported in adolescents. To accomplish diagnosis and differential diagnosis, accurate history and physical examination are mandatory. In all cases reported in the literature, further instrumental analyses were performed, including ultrasound, CT, and/or MRI scan. International Ovarian Tumor Analysis (IOTA) rules have not yet been validated in the pediatric population. Because of the advantages of the laparoscopic procedures, it is often preferred in pediatric population, also to help preserve as much ovarian parenchyma and salpinx if thought possible. The incidence of malignant adnexal masses in the pediatric population is reported to range from 4% to 9%, accounting for 1% of all pediatric cancers. Conclusion: Giant paratubal cysts in adolescent females are extremely rare and usually benign. A fertility-sparing laparoscopic surgery should be the preferable option whenever possible. Considering the rarity of these conditions, further investigations are needed to exclude the possibility of a malignant evolution.

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Paraovarian cysts (POCs) develop within the broad ligament of the uterus. POCs are considered to be giant when the threshold of 150 mm is exceeded. Clinical signs and symptoms occur as a consequence of the pressure effect on adjacent organs or due to complications. Abdominal ultrasonography, computed tomography or magnetic resonance imaging are useful imaging tools, but most often the exact origin of such voluminous cysts is revealed only by surgical exploration. The review aims to appraise and update the diagnostic, the histological aspects and the treatment of the giant POCs in rare cases. We carried out a systematic search in Medline-PubMed, Google Scholar and ResearchGate electronic databases. Twenty-seven papers fulfilling the selection criteria were included in the review. The data extracted included information about first author, year of publication, country, patient age, size and side of the POCs, symptoms, tumoral markers, imaging methods, preoperative diagnosis, surgical management and histopathological findings. Although not very numerous, all the studies highlighted the low incidence of giant POCs, the impossibility of establishing the origin of the cystic mass by clinical and imaging methods even with advanced technical tools and the low risk of torsion (11.1%). Despite the recognized benign nature of POCs, we found an unexpected high percent (25.9%) of borderline giant POCs. Surgical excision is the only treatment option. Ovarian-sparing surgery was performed in 85.1% of the cases, and minimally invasive techniques were applied in only 42.9% of the patients, which demonstrates the need of a high-level laparoscopic expertise. Knowledge of this pathology, its recognition as a possible etiology of an abdominopelvic cyst, and a higher awareness of the possibility of a borderline histology in giant POCs are required for the proper management of these particular cases.

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This report presents an unusual case of multiple paraovarian cysts that required emergency surgery due to a paraovarian cyst being entrapped by another paraovarian cyst. Laparoscopic surgery is considered useful for diagnostic and therapeutic purposes and is, therefore, recommended owing to difficulty in differentiating paraovarian cysts from ovarian cysts.

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Fallopian tube torsion secondary to paraovarian or paratubal cyst is a rare gynecological cause of acute abdomen. The condition has no distinctive signs and symptoms. There are no characteristic features on radiological imaging, making preoperative diagnosis very difficult. Paraovarian cysts that are less than 4 cm in size are mostly asymptomatic and found incidentally during a pelvic examination or radiological imaging. It seldom leads to any complications like fallopian tube torsion hemorrhage or rupture. We report a case of an adolescent girl, who presented with severe abdominal pain. Transabdominal ultrasound was suggestive of a cystic structure less than 4 cm in size in the left adnexa. Doppler ultrasound showed normal blood flow to both ovaries. Diagnostic laparoscopy was performed, which revealed a twisted left-sided fallopian tube with a fimbrial paraovarian cyst. Detorsion and paraovarian cystectomy was performed. Although paraovarian cysts are mostly asymptomatic, those arising near the fimbrial end can lead to torsion of the fallopian tube, therefore it should always be considered a possible cause of acute abdomen in adolescent girls with adnexal cysts on ultrasound. Timely surgical intervention can prevent complications such as fallopian tube necrosis, gangrene, removal of the tube, and its long-term implications especially in women of the reproductive age group.

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BACKGROUND: Isolated fallopian tube torsion (IFTT) is a rare cause of gynecological acute abdomen, is easily misdiagnosed and often has a delay in diagnosis. IFTT with paraovarian cysts is most frequently reported in studies. Here, we reported a patient diagnosed with IFTT associated with a paraovarian cyst, and we conducted a literature review for IFTT, aiming to identify valuable information that will be helpful for diagnosis and treatment for fallopian tube torsions. CASE PRESENTATION: A 13-year-old girl presented with a 10-day history of right lower abdominal pain that worsened 2 days before presentation. On presentation, ultrasound showed a 5.8 * 5.5 cm hypoechoic cyst adjacent to the right ovary, and between the cyst and ovary, a tortuous thickened tube was visualized. Laparoscopy revealed a triple torsion of the right fallopian tube with a 6-cm paraovarian cyst, and tubal conservation surgery was performed. The postoperative course was uneventful. Histopathological diagnosis revealed serous papillary cystadenoma. CONCLUSION: Paraovarian cystic dilatation often occurs in adolescence and can induce fallopian torsion when the size of the cyst reaches 5-cm. In our review, the median age of patients diagnosed with IFTT with paraovarian cysts was 15 years old, and the main clinical manifestation was emergency abdominal pain. The associated symptoms were variable, and vomiting was the most commonly associated symptom. Salpingectomy was the most common procedure performed; however, timely surgical intervention can effectively avoid salpingectomy.

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Unilateral lower quadrant pain is a common presenting complaint in the emergency room with a wide differential. It is important to consider fallopian tube torsion in the differential, especially in premenopausal women, as fertility-sparing detorsion, especially in a woman with a previous salpingectomy or other fertility-affecting surgery, is essential. This case report is of a 25-year-old woman with worsening left lower quadrant abdominal pain over 24 h found to have an extraovarian cystic mass. When taking into consideration the patient with a history of contralateral fallopian tube torsion secondary to a paraovarian cyst, now presenting with left lower quadrant abdominal pain and a cystic extraovarian mass, immediate laparoscopic evaluation was warranted. Immediate intervention revealed an isolated fallopian tube torsion and resulted in surgical preservation of fertility.

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Massive ovarian edema is a rare gynecological entity resembling a solid ovarian tumor due to the accumulation of edematous fluid within the ovarian stroma. This condition can be easily mistaken for a neoplasm, resulting in overtreatment by removal of the whole affected ovary. The present study describes the case of a 28-year-old woman who experienced massive ovarian edema with paraovarian cyst torsion treated with laparoscopic surgery. The patient experienced lower abdominal pain lasting for 1 week and visited a local clinic. The ultrasonographic examination revealed two loculated ovarian masses and the patient was then referred to the hospital. Transvaginal ultrasonographic examination revealed a 77.9-mm cystic lesion and a 57.7-mm solid lesion in the left adnexa. A magnetic resonance imaging examination revealed a 55-mm lesion with multiple peripheral ovarian follicles, which was isointense on T1-weighted images and hyperintense on T2-weighted images, and a 75-mm cystic lesion, without a solid component, which was hypointense on T1-weighted images and hyperintense on T2-weighted images in the left adnexa. There were no observed abnormalities of the right adnexa or uterus. Laparoscopic surgery was performed, based on a clinical suspicion of massive ovarian edema with paraovarian cyst torsion. Intraoperatively, a paraovarian cyst was identified in the left adnexa that was twisted 360˚. The size of the enlarged left ovary was reduced to almost normal following the detorsion of the left adnexa. The final diagnosis was that of a massive ovarian edema, which was treated by resecting the paraovarian cyst, while preserving the whole left ovary. The pathological examination of the resected paraovarian cyst revealed a serous cystadenoma. Therefore, the present study suggests that the presence of massive ovarian edema should be taken into consideration when encountering a complex solid ovarian mass with multiple peripheral ovarian follicles, particularly in cases with a history of recurrent abdominal pain.

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Rubinstein-Taybi syndrome is an extremely rare autosomal dominant genetic disorder that occurs in 1/125,000 and is characterized by distinctive facial appearance, short stature, mild to severe mental retardation, and higher risk for cancer. In addition, variable organ anomalies had been reported. Paraovarian cyst causing torsion of the ipsilateral fallopian tube is less common, with an estimated incidence of 1/1,500,000, but it can adversely affect tubal function. It occurs mainly in women in the reproductive age and is very rare in prepubescent girls. Here, we described the successful treatment of an extremely rare case of paraovarian cyst causing torsion of the ipsilateral fallopian tube in a patient with Rubinstein-Taybi syndrome. A 14-year-old girl with Rubinstein-Taybi syndrome was referred to our hospital for abdominal pain. Her medical history was unremarkable, except for moderate hirsutism and keloid scar. Physical examination revealed tenderness in the lower abdominal midline. The preoperative diagnosis was torsion of a left ovarian cyst. An exploratory laparoscopy was performed because of acute abdominal pain and revealed a left fallopian tube that was twisted twice due to an ipsilateral paraovarian cyst. The huge paraovarian cyst required laparotomy cystectomy, and the left ovary was preserved. Her postoperative course was uncomplicated. Preoperative diagnosis of paraovarian cysts can be difficult. The moderate hirsutism seen in our patient suggested the presence of a large paraovarian cyst due to androgen receptor-mediated effects. Therefore, Rubinstein-Taybi syndrome patients with hirsutism should be screened and assessed by pediatric surgeons for the presence of paraovarian cysts.

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BACKGROUND: Determination of the clinical characteristics associated with adnexal torsion involving paraovarian cysts in pediatric and adolescent populations. METHODS: Retrospective review of all cases of paraovarian cysts operated on in our department between 2007 and 2019. Demographic characteristics, clinical and sonographic findings were reviewed. RESULTS: The cohort was composed of 39 pediatric and adolescent patients with an operative diagnosis of adnexal masses located in the paraovarian area. The patients were classified into two groups: 19 girls (48.7%) with a confirmed operative diagnosis of adnexal torsion and 20 girls (51.3%) without torsion. The preoperative diagnosis of adnexal torsion was correct in ≈70% of the cases. The mean BMI were similar in both groups. The preoperative sonographic detection rate of paraovarian cysts was also similar (11/19 [57.9%] vs. 14/20 [70.0%]; P = 0.514). The mean cyst diameter did not differ between groups, nor did the classification into cyst size groups (≤50 mm, 51-99 mm and ≥100 mm). CONCLUSION: Adnexal torsion is a common complication diagnosed in girls undergoing surgery for paraovarian cysts, and is not associated with sonographic appearance or cyst diameter. In order to prevent torsion, surgical removal of paraovarian cysts should thus be considered in young girls undergoing surgery for paraovarian cysts. TYPE OF STUDY: Retrospective case series. LEVEL OF EVIDENCE: IV.

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BACKGROUND: Paraovarian/paratubal cysts constitute about 10% of adnexal masses and are usually small and asymptomatic. A huge paratubal cyst complicated by adnexal torsion is a rare cause of acute low abdominal pain. CASE REPORT: We report the case of an obese 31-year-old nulliparous woman who presented with a large pelvic cyst causing ovarian torsion. The size of the mass (~25 cm) caused pain, and obesity led to explorative laparotomy, which showed a huge central abdominal-pelvic cyst arising from the right adnexa. Cystectomy was technically impossible, so all the adnexa was removed. Pathologic diagnosis revealed a papillary serous cystadenoma with torsion of all structures. CONCLUSION: A giant paratubal cystadenoma is a rare condition and management is challenging. If there are clinical and imaging signs of torsion, it should be approached like any other adnexal mass and surgery should be urgent in order to avoid irremediable compromise of ovarian function.

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This article describes the urinogenital condition of three female Iberian ibexes (Capra pyrenaica-one infertile 3-yr-old adult and two prepubertal animals aged 1 (PP1) and 2 (PP2) yr, respectively, all raised in captivity. All showed constant urinal dribbling, leading to ulcerative dermatitis in the vulvar area. Housed in a stable with other females, the adult did not become pregnant after male contact in either of two consecutive mating seasons. Vaginoscopy and laparoscopic exploration performed on the prepubertal females revealed abnormalities of the vagina and urinary bladder. Ultrasound examination revealed atrophy of the left kidney in the adult female and PP1, and of the right kidney in PP2, with degeneration of the renal pelvis. A paraovarian cyst with hydrosalpinx was also detected in the left oviduct of the adult female. Postmortem analysis of the adult and PP2, which shared a mother, confirmed an extramural single ectopic ureter with vaginal insertion associated with atrophy of the ipsilateral kidney. Though PP1 was officially unrelated to the latter animals, all three might have had a common ancestor in their lineages.

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INTRODUCTION: Despite their relative frequency, paraovarian cyst received only scant attention. Clinician should be aware of the complications of paraovarian cyst. OBJECTIVE: To analyse the clinical profile, complications and management of paraovarian cyst. MATERIALS AND METHODS: Retrospective analysis of 51 patients with operative diagnosis of paraovarian cyst was carried out at our institution over a 5-year period. RESULTS: Majority (60.78%) of paraovarian cysts were found in the third and fourth decades, and the mean age of the patients was 31.8 years. 62.74% patients with paraovarian cyst presented with abdominal pain, and the rest were an incidental finding. Ultrasound made a correct diagnosis in 47.05% of patients. Mean size of paraovarian cyst was 7.51 cm. Complications of paraovarian cyst noted in our study are cyst enlargement (79.62%), adnexal torsion (18.51%), haemorrhage (7.4%), rupture (1.85%) and benign tumour (12.96%). 84.31% paraovarian cysts were managed by laparoscopy. Fertility-sparing surgery was done in 57.39% of paraovarian cysts. CONCLUSION: Paraovarian cyst should be considered in the differential diagnosis of adnexal mass. The importance of differentiating it from ovarian cyst cannot be overemphasized. Laparoscopic approach and preferably a fertility-sparing surgery should be considered in the management of complications of paraovarian cyst.

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Introducción: El quiste paraovárico representa el 10 al 20% de las masas anexiales, genera síntomas cuando causa torsión de los anexos, pero es poco frecuente, la torsión aislada de las trompas tiene una incidencia de 1 en 1.5 millones de mujeres. Objetivo: Presentar un caso de torsión tubárica aislada como complicación de un quiste paraovárico en el Hospital Universitario de Santander. Caso clínico: Paciente femenino de 17 años, presenta dolor en hemiabdomen inferior; hallazgo ecográfico, quiste paraovárico derecho; mejora la sintomatología en 24 horas; egreso con recomendaciones; regresa dos meses después por exacerbación del dolor, masa anexial de 5 centímetros, laboratorios normales, ecografía reporta ovario aumentado de tamaño y trompa de paredes engrosadas; se realiza laparoscopia; se encuentra trompa derecha torcida con necrosis y quiste paraovárico derecho de 6 x 5cm. Discusión: El diagnóstico de quiste paraovárico es generalmente incidental por ecografía, cuando se complica con torsión, se presenta dolor abdominal pélvico asociado a náuseas y vómito, al examen físico el 42.9% de las mujeres presentan a la palpación una masa anexial; la paciente del caso presenta dolor abdominal, con masa anexial palpable evidenciada en ecografía, por lo cual se realiza laparoscopia. El tratamiento del quiste paraovárico es el seguimiento, sin embargo, si aumentan de tamaño o hay persistencia, debe retirarse quirúrgicamente por el riesgo de torsión de anexos. De presentar torsión el manejo depende del estado de la trompa, al realizar destorsión persiste la coloración violácea, se debe realizar salpingectomía y cistectomía procedimiento realizado en esta paciente. Conclusiones: El diagnóstico de la torsión tubárica se realiza con clínica de dolor abdominal pélvico agudo, náuseas, vómito y presencia de masa anexial al tacto vaginal. La laparoscopia es el tratamiento de elección, cuyo manejo con cistectomía y salpingectomía que depende del compromiso vascular de los anexos. [Sepúlveda-Agudelo J, Torrado-Arenas DM, Martínez-Moreno N. Torsión tubárica aislada como complicación de un quiste paraovárico en el Hospital Universitario de Santander, Colombia. MedUNAB 2017; 20(3): 393-398].

Introduction: The paraovarian cyst represents from 10% to 20% of the adnexal masses, it generates symptoms when it causes torsion of the annexes but this is rare. The isolated torsion of the fallopian tubes has an incidence of 1 in 1.5 million women. Objective: To show a case of isolated fallopian tube torsion (IFTT) as a complication of a paraovarian cyst at the University Hospital of Santander. Clinical case: A 17-year old female patient who presents pain in lower hemi-abdomen. After performing the ultrasound, a right paraovarian cyst is found. Her symptomatology improves within 24 hours. Therefore, she is discharged after telling her some recommendations. Two months later, she returns because of pain exacerbation caused by an adnexal mass of 5 centimeters. Now, her lab tests are normal but her new ultrasound reports an enlargement in the ovary and thickened fallopian tubes, so a laparoscopy is performed. This test shows that the right fallopian tube is twisted with necrosis and a right paraovarian cyst of 6 x 5cm. Discussion: The diagnosis of paraovarian cyst is usually incidental by ultrasound; but when there is a torsion complication, pelvic abdominal pain associated with nausea and vomiting is presented. When the physical examination is performed, 42.9% of women present an adnexal mass on palpation. The patient of this clinical case shows abdominal pain, including a tangible adnexal mass, which is evidenced by the ultrasound. For this reason, a laparoscopy is performed. The treatment of the paraovarian cyst is the follow-up; however, if it increases in size or there is persistence, it should be removed surgically due to the risk of torsion of its annexes. If it presents torsion, its handling will depend on the state of the tube. So, if at the moment of performing a distortion in it the violaceous color persists, a salpingectomy and a cystectomy must be performed in this patient. Conclusions: The diagnosis of fallopian tube torsion is performed if the patient has clinical symptoms such as acute pelvic abdominal pain, nausea, vomiting and presence of adnexal mass when performing a digital vaginal examination. Laparoscopy is the treatment of choice, and its management with cystectomy and salpingectomy depends on the vascular commitment of the cyst annexes. [Sepúlveda-Agudelo J, Torrado-Arenas DM, Martínez-Moreno N. Isolated Fallopian Tube Torsion as a Complication of a Paraovarian Cyst in the University Hospital of Santander, Colombia. MedUNAB 2017; 20(3): 393-398].

Introdução: o cisto paraovariano representa 10 a 20% das massas anexiais, gera sintomas quando provoca a torção dos anexos, mas é raro, a torção isolada dos tubos tem uma incidência de 1 em 1,5 milhão de mulheres. Objetivo: Apresentar um caso de torção tubária isolada como complicação de um cisto paraovariano no Hospital Universitário de Santander. Caso clínico: paciente do sexo feminino de 17 anos, apresenta dor em hemiabdomen inferior; com ultra-som foi descoberto um cisto paraovariano direito; no prazo de 24 horas, melhora a sintomatologia; sai de alta, com recomendações. Retorna dois meses depois, por causa da dor intense e uma massa anexial de 5 centímetros (cm), como resultado nos laboratórios normais. O ultra-som revelou o aumento do tamanho do ovário e o bico afundado; é realizada uma laparoscopia; O tronco torcido direito é encontrado com necrose e cisto paraovariano direito de 6 x 5cm. Discussão: O diagnóstico do cisto paraovariano geralmente é descoberto por incidente, ao se fazer a ultrassonografia, quando é um caso complicado com torção, a dor abdominal pélvica está associada a náuseas e vômitos; no exame físico, 42,9% das mulheres apresentam palpação, uma massa anexial. A paciente, no caso apresenta dor abdominal, com uma massa anexial palpável evidenciada no ultra-som, razão pela qual a laparoscopia é realizada. O tratamento do cisto paraovariano é o acompanhamento, no entanto, se eles aumentam de tamanho ou haja persistência, ele deve ser removido cirurgicamente devido ao risco de torção de anexos. Se a torção persiste, o tratamento depende do estado do tubo e, se ao realizar a distorção, a cor violácea persiste, a salpingectomia e a cistectomia devem ser realizadas nessa paciente. Conclusões: o diagnóstico de torção tubária é feito com sintomas de dor abdominal pélvica aguda, náuseas, vômitos e presença de massa anexial ao toque vaginal. A laparoscopia é o tratamento de escolha, cujo manejo com cistectomia e salpingectomia depende do comprometimento vascular dos anexos. [Sepúlveda-Agudelo J, Torrado-Arenas DM, Martínez-Moreno N. Torção tubária isolada como uma complicação de um cisto paraovariano no Hospital Universitário de Santander, Colômbia. MedUNAB 2017; 20(3): 393-398].

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