J Korean Surg Soc.  2009 Jan;76(1):36-42. 10.4174/jkss.2009.76.1.36.

Clinical Experiences of Fitz-Hugh-Curtis Syndrome

• Ham YC
• Lee KL
• Shin DG
• Kang SK
• Park SS
• Yoon J
• Kim HJ
• Kim IM

• KMID: 2040602
• DOI: http://doi.org/10.4174/jkss.2009.76.1.36

Abstract

PURPOSE
Fitz-Hugh-Curtis (FHC) syndrome has been described as perihepatitis associated with pelvic inflammatory disease during surgery. Recently, on computerized tomography a linear enhancement of the liver capsule was detected in a patient with FHC syndrome. We studied to evaluate the clinical course of the disease.
METHODS
Sixteen patients diagnosed with FHC syndrome from CT findings were retrospectively studied from April, 2006 to June, 2008.
RESULTS
The mean age of the patients was 25.9 (19~35) years and mean duration of abdominal pain was 3.9 (1~14) days. The most common complaint was right upper quadrant area pain (11 cases, 68.8%). 12 patients showed leukocytosis and all the patients had elevated serum C-reative protein levels. All the patients had normal liver function. Among the 9 patients which had polymerase chain reaction test for sexually transmitted disease (Chlamydia trachomatis, Ureaplasma urealyticum, Neisseria gonorrheae, Mycoplasma hominis), all showed more than one positive results (Chlamydia trachomatis 6 cases, Ureaplasma urealyticum 6 cases, Mycoplasma hominis 2 cases). On simple abdomen X-ray, 7 cases (43.8%) showed paralytic ileus. 14 cases received only antibiotic treatment, but 1 case had to take operation (laparoscopic-assisted adhesiolysis) due to constant abdominal pain and prolonged ileus.
CONCLUSION
It is important to rule out FHC syndrome by using CT findings, especially young women with right upper abdominal pain and PID. Usually, FHC syndrome can be treated easily with proper antibiotics.

Keyword

Fitz-Hugh-Curtis syndrome; Computed tomography; Perihepatitis; Pelvic inflammatory disease

MeSH Terms

Abdomen
Abdominal Pain
Anti-Bacterial Agents
Chlamydia Infections
Female
Gonorrhea
Hepatitis
Humans
Ileus
Intestinal Pseudo-Obstruction
Leukocytosis
Liver
Mycoplasma
Mycoplasma hominis
Neisseria
Pelvic Inflammatory Disease
Peritonitis
Polymerase Chain Reaction
Retrospective Studies
Sexually Transmitted Diseases
Ureaplasma urealyticum
Anti-Bacterial Agents
Chlamydia Infections
Hepatitis
Pelvic Inflammatory Disease
Peritonitis

Figure

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  Fig. 1 Abdominopelvic CT arterial phase. Linear subcapsular enhancement at the anterior surface of the liver (arrow).

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  Fig. 2 Sonographic finding of pelvic fluid collection.

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  Fig. 3 Operative finding of hepatic capsular inflammation with adhesion of capsule to peritoneum.

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  Fig. 4 Operative finding of pelvic inflammation with adhesion of uterus to ileum.

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