Clinical Experiences of Fitz-Hugh-Curtis Syndrome

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.