Torsion of the fallopian tube and acute pelvic pain: an unusual presentation of genital tuberculosis  Tirso Perez-Medina, Ph.D., Beatriz Bueno, M.D., Teresa Redondo, M.D., Isabel Gallego, M.D., José Bajo-Arenas  Fertility and Sterility  Volume 89, Issue 6, Pages 1810-1811 (June 2008) DOI: 10.1016/j.fertnstert.2007.09.063 Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Abdominal ultrasound: sonolucent structure on the left side corresponding to severe hydrosalpinx. Fertility and Sterility 2008 89, 1810-1811DOI: (10.1016/j.fertnstert.2007.09.063) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Laparoscopic view of the internal genital organs affected. Tuberculosis has to be ruled out when this characteristic peritoneal spread (miliar pattern) along with the ascites is present in a young woman. Fertility and Sterility 2008 89, 1810-1811DOI: (10.1016/j.fertnstert.2007.09.063) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Left hydrosalpinx. Conglutinated, solid aspect of the tube. Adhesions affecting the fimbrial ostium result in tubal occlusion and subsequent dilatation. Fertility and Sterility 2008 89, 1810-1811DOI: (10.1016/j.fertnstert.2007.09.063) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 4 Confluent necrotizing granuloma occupy the endosalpinx. Typical granulomatous reaction is present of epithelioid cells, giant cells, and lymphocytes arranged in a nodular configuration. Epithelial tubal folds can be clearly seen (hematoxylin and eosin stain, magnification: ×400). Fertility and Sterility 2008 89, 1810-1811DOI: (10.1016/j.fertnstert.2007.09.063) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions