Fitz-Hugh-Curtis Syndrome
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Michelle Mersch
A 37-year-old gravida 7 para 2-0-5-2 woman presented for scheduled bilateral salpingectomy with desired surgical sterilization. Her medical history included normal spontaneous vaginal delivery 6 weeks prior and Trichomonas vaginalis infection treated before pregnancy. The patient reported no past abdominal surgery or additional sexually transmitted infections. Laparoscopic intra-abdominal examination revealed numerous “violin-string” adhesions to the anterior surface of the liver, with an otherwise normal-appearing liver capsule and gall bladder (image A). Extensive adhesions also involved the omentum, small and large bowel, uterus, and bilateral adnexa (image B).
Fitz-Hugh Curtis syndrome, or perihepatitis, occurs in approximately 10% of women with acute pelvic inflammatory disease and is often asymptomatic with chronic infections.1,2 Perihepatitis can manifest as a patchy, purulent, and fibrinous exudate (violin string adhesions) on laparoscopy. It most prominently affects the anterior surfaces of the liver, sparing the liver parenchyma, and is not associated with prominent liver dysfunction.3 The patient had successful bilateral salpingectomy with lysis of adhesions and an uncomplicated postoperative course.
References
1. WangSP, EschenbachDA, HolmesKK, WagerG, GraystonJT. Chlamydia trachomatis infection in Fitz-Hugh-Curtis syndrome. Am J Obstet Gynecol. 1980;138(7 pt 2):1034-1038. doi:10.1016/0002-9378(80)91103-5Search in Google Scholar PubMed
2. ReichertJA, ValleRF. Fitz-Hugh-Curtis syndrome: a laparoscopic approach. JAMA. 1976;236(3):266-268.10.1001/jama.1976.03270030020021Search in Google Scholar
3. SellorsJ,MahonyJ, GoldsmithC, et al.The accuracy of clinical findings and laparoscopy in pelvic inflammatory disease. Am J Obstet Gynecol. 1991;164(1 pt 1):113-120. doi:10.1016/0002-9378(91)90639-9Search in Google Scholar PubMed
© 2020 American Osteopathic Association
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- Official Call: 2020 Annual Business Meeting of the American Osteopathic Association
- LETTER TO THE EDITOR
- LETTER TO THE EDITOR
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- Osteopathic Manipulative Treatment and Psychosocial Management of Dysmenorrhea
- CLINICAL IMAGES
- Fitz-Hugh-Curtis Syndrome
- Straight Back Syndrome
Articles in the same Issue
- AOA COMMUNICATION
- Official Call: 2020 Annual Business Meeting of the American Osteopathic Association
- LETTER TO THE EDITOR
- LETTER TO THE EDITOR
- ORIGINAL CONTRIBUTION
- Preoperative Osteopathic Manipulative Therapy Improves Postoperative Pain and Reduces Opioid Consumption After Total Knee Arthroplasty: A Prospective Comparative Study
- Novel Dual-Fluorescent Mitophagy Reporter Reveals a Reduced Mitophagy Flux in Type 1 Diabetic Mouse Heart
- Effect of Opioid Prescribing Education for Obstetrics and Gynecology Residents in a Safety-Net Hospital
- Evaluating Financial Conflicts of Interest Among Contributors to Clinical Practice Guidelines of the American College of Obstetricians and Gynecologists
- CLINICAL PRACTICE
- Osteopathic Physician Mortality in the Influenza Pandemic of 1918-1920
- CASE REPORT
- Sister Mary Joseph Nodule in a Patient With Advanced Prostate Cancer
- Osteopathic Manipulative Treatment and Psychosocial Management of Dysmenorrhea
- CLINICAL IMAGES
- Fitz-Hugh-Curtis Syndrome
- Straight Back Syndrome
