Intestinal obstruction caused by an ectopic fallopian tube in a child: Case report and literature review

The authors present the case of a prepubertal 14-year-old girl who was admi tted for an acute abdominal pain, fever, and vomiting. She was in a poor ge neral state, having recently suffered a weight loss of 5 kg. A plain abdomi nal x-ray disclosed signs of mechanical ileus. An abdominal ultrasound scan showed a normal uterus, a normal right-sided ovary; but no left ovary. An emergency laparoscopy found a normal uterus with complete absence of the le ft ovary and salpinx, the tipper left dome of the uterus being smooth with no visible horn. The right ovary and salpinx were normal. Intestinal obstru ction was caused by a strangulating cordlike structure of unclear origin. A fter converting to a laparotomy, we found an abnormal fallopian tube insert ed in the left parieto-colic groove. The tube extended next on the lateral sigmoid mesentery and wrapped itself around the ileum, provoking a local st rangulation and an ischemic covered bowel perforation. The bowel perforatio n was treated by a segmental bowel resection. Careful dissection of the cor dlike structure disclosed a true rudimentary fallopian tube with hypotrophi c fimbriae and a small distal round structure containing ovarian tissue. Th ese structures were removed entirely. A review of the literature on this ra re situation is presented and discussed. J Pediatr Surg 36:508-510. Copyrig ht (C) 2001 by W.B. Saunders Company.