Isolated Fallopian Tube Torsion Associated with Tubal Pregnancy

A 31-year-old G7, P2 woman presented to the emergency department with sudden, severe lower-left abdominal pain, vomiting, and 39 days of amenorrhea. Serum chorionic gonadotropin (hCG) level was 94.3 mIU/mL. Transvaginal ultrasonography revealed no lesions of the adnexa or uterine gestational sac. An emergency diagnostic laparoscopy was performed for suspected ectopic pregnancy, revealing subserosal uterine fibroid and unruptured, swollen left fallopian tube with isolated torsion and bleeding, which led to hemoperitoneum (figure).