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Ruptured salpingitis isthmica nodosa: a rare cause for spontaneous haemoperitoneum
  1. Dora Huang1,
  2. Sandon Lowe2,
  3. Pravena Kumaran2 and
  4. Kay Tai Choy1
  1. 1Department of Surgery, Austin Health, Heidelberg, Victoria, Australia
  2. 2Department of Surgery, North West Regional Hospital, Burnie, Tasmania, Australia
  1. Correspondence to Dr Dora Huang; dorahuang4{at}gmail.com

Abstract

Salpingitis isthmica nodosa (SIN) is the nodular swelling or diverticulum of the isthmus of the fallopian tube. It is most commonly identified when investigating female infertility or in association with ruptured ectopic pregnancies. We experienced a rare and atypical presentation of SIN. A 33-year-old woman presented with a 1-hour history of acute lower abdominal pain associated with nausea and vomiting. CT and pelvic ultrasound revealed haemoperitoneum with no radiological evidence for its aetiology. Initial beta-human chorionic gonadotropin excluded ectopic pregnancy. A diagnostic laparoscopy was performed following clinical deterioration of the patient. Active bleeding of the right fallopian tube was identified and managed with a right partial salpingectomy, with subsequent histopathology revealing ruptured SIN. There have been no reported cases of SIN being a primary cause for an acute abdomen or haemoperitoneum in the absence of an ectopic pregnancy, making this case a surgical novelty.

  • general surgery
  • obstetrics and gynaecology

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Footnotes

  • Contributors The report was written by DH, SL and PK. DH and SL conducted the literature search. KTC supervised and proof-read.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.