Fitz-hugh-curtis syndrome: A rare disease in the differential diagnosis of acute abdomen

Abstract

Fitz-Hugh-Curtis syndrome (FHCS) is defined as peritoneal capsule inflammation of the liver. This disease is thought to be a complication of an ascending genital infection. A young sexually active woman was admitted to our emergency department with an acute right upper quadrant abdominal pain and diagnosed as FHCS via computed tomography examination. She was treated conservatively with adequate antibiotherapy. This syndrome should be kept in mind in the differential diagnosis of acute abdominal pain diseases to avoid unnecessary surgery.

Fitz-Hugh-Curtis syndrome: a case of perihepatitis in ‘mosaic’ pattern

“…There is no single diagnosis goldstandard, so it may be misdiagnosed as many other disorders like acute cholecystitis, right pyelonephritis, pneumonia and even acute appendicitis. [1][2][3][4][5] In the past, the diagnosis was made by visual or laparoscopic inspection, showing the perihepatic adhesions and the treatment was made by adhesiotomy. Now, with the development of imaging strategies, it can be diagnosed by non-invasive methods.…”

“…Now, with the development of imaging strategies, it can be diagnosed by non-invasive methods. 1 The syndrome can be cured by oral administrations of appropriative antibiotics such as tetracycline, doxycycline or erythromycin. 6 On the other hand, surgical treatment (laparoscopic adhesiolysis) can be preferred only for cases that were unresponsive to antibiotic therapy.…”

“…6 On the other hand, surgical treatment (laparoscopic adhesiolysis) can be preferred only for cases that were unresponsive to antibiotic therapy. 1 Stasis of blood within hepatic sinusoids and the altered haemodynamics that occur with hepatic venous outflow obstruction manifest as a 'mosaic' enhancement of the hepatic parenchyma. Hepatic venous outflow obstruction can occur at the following different levels: the heart (in the setting of congestive heart failure such as tricuspid regurgitation, cardiomyopathy, constrictive pericarditis and core pulmonale), inferior vena cava (IVC), hepatic veins (BCS) and at the level of sinusoids and central veins (sinusoidal obstruction syndrome (SOS)).…”