Intermittent partial adnexal torsion after electrosurgical tubal ligation.

Intermittent partial adnexal torsion after electrosurgical tubal ligation has been suggested as a cause of chronic pelvic pain. Little is present in the literature describing this entity or its characteristics. Unlike complete torsion of the fallopian tube, ovary, or paratubal cyst, intermittent adnexal torsion is more subtle in both clinical features and laparoscopic findings. It appears to be an underrecognized cause of pelvic pain in some women after tubal ligation. Thus these women may be subjected to many diagnostic tests and extensive evaluations with negative findings. It is not uncommon for the diagnosis to be overlooked even at the time of pelviscopic evaluation. A woman experienced the characteristic chronic, intermittent, left lower quadrant pain after electrosurgical tubal ligation. At the time of a third laparoscopic evaluation, the diagnosis of intermittent partial adnexal torsion was made, and she was treated with distal salpingectomy and ovarian fixation. She had complete resolution of her long-standing pain.