| Clinical feature of Fitz-Hugh-Curtis syndrome: Analysis of 25 cases |
| Hyeon Woong Yang, M.D., Sung Hee Jung, M.D., Hyun Young Han1, Anna Kim, M.D.,
Yun Jung Lee, M.D., Sang Woo Cha, M.D., Hun Go, M.D., Gi Young Choi, M.D.,
Soung Hoon Cho, M.D., Sin Hyung Lim, M.D. |
| Department of Internal Medicine, 1Department of Radiology, Eulji University College of Medicine, Eulji University Hospital, Daejeon, Korea |
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| ABSTRACT |
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Background/Aims
Fitz-Hugh-Curtis syndrome is defined as perihepatitis associated with pelvic inflammatory
disease (PID). We retrospectively analyzed clinical and laboratory manifestations as well as the
therapeutic response in patients with clinically diagnosed Fitz-Hugh-Curtis syndrome. Methods: A cohort of
25 patients with PID and perihepatitis (as diagnosed by dynamic abdominal computed tomography (CT)) was
enrolled. The prognosis, clinical manifestations, and physical examination, laboratory, and CT findings were
analyzed. Results: The mean (±SD) age of the patients was 32(±8) years, and all of them were sexually
active, premenopausal women, and presented with abdominal pain. Of these, 52% complained of vaginal
discharge. On physical examination, right upper-quadrant tenderness was the most common finding (84%),
with lower-abdominal tenderness being present in 20% of patients. On laboratory examination, erythrocyte
sedimentation rate and C-reactive protein were increased in 76% and 92% of the patients, respectively. The
white blood cell count was increased in 60% of them. Most patients had a normal liver function test. Using
a specimen of the cervical discharge, the polymerase chain reaction to test for Chlamydia trachomatis were
positive in 87% (13/15) of the patients, and Chlamydia antigen was found in 75% (9/12) of them. Dynamic
abdominal CT revealed subcapsular enhancement of the liver in the arterial phase. All of the patients improved
with antibiotic therapy. Conclusions: Symptoms and physical findings suggestive of PID are not present in
many patients with Fitz-Hugh-Curtis syndrome. When a premenopausal woman complains of upper abdominal
pain and shows CT findings compatible with perihepatitis, examination of cervical discharge would be
recommended to assess the possibility of Fitz-Hugh-Curtis syndrome. (Korean J Hepatol 2008;14:178-184) |
| KeyWords:
Fitz-Hugh-Curtis syndrome; Perihepatitis; Pelvic inflammatory disease; Chlamydia trachomatis |
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