Perihepatitis with pelvic inflammatory disease (PID) on MDCT: characteristic findings and relevance to PID

Kim, Ji Young; Kim, Yongsoo; Jeong, Woo Kyoung; Sang-Hwa, Song; Cho, On Koo

doi:10.1007/s00261-008-9472-9

Cited by 29 publications

(16 citation statements)

References 24 publications

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“…Capsular enhancement on the arterial phase of CT imaging may reflect increased blood flow at the inflamed hepatic capsule, which is consistent with the laparoscopic findings of moist inflammation with injection of the vessels and exudate formations on the anterior surface of the liver. While enhancement on the portal or delayed phase images may reflect early events in capsular fibrosis, the most commonly enhanced area is the anterior surface of the right lobe, and the depth of enhancement is usually linear or less than 0.5 cm 9. The perihepatic enhancement can be shown as string, broadband, or mixed appearance 19.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is important to search the entire abdominal CT image for other causes that can result in perihepatitis. It is helpful to also review the associated findings of PID, such as pelvic ascites, oophoritis, endometritis, cervicitis and tubo-ovarian abscess, for the diagnosis of FHCS 9. Perihepatitis is also a rarely diagnosed complication of systemic lupus erythematosus (SLE), requiring consideration in SLE patients with RUQ pain 21.…”

Section: Discussionmentioning

confidence: 99%

“…Increased enhancement along the hepatic surface on computed tomography (CT) may suggest the diagnosis of FHCS 4,7. Recent studies demonstrated that dynamic abdominal CT, including an arterial phase scan, can significantly improve the depiction of perihepatic enhancement 8,9. Using this technique, the sensitivity and the accuracy of diagnosing FHCS can be markedly increased during the evaluation of female patients with acute right upper quadrant (RUQ) pain or suspicions of FHCS.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Features of Fitz-Hugh-Curtis Syndrome in the Emergency Department

et al. 2012

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Purpose Fitz-Hugh-Curtis Syndrome (FHCS) is a clinical entity characterized by inflammation of the liver capsule associated with genital tract infection. The aim of this study is to provide physicians with clinical suggestions for diagnostic approaches based on a series of patients who were diagnosed with FHCS. Materials and Methods We conducted a retrospective study of patients who were diagnosed with FHCS after presenting to the emergency department (ED). The symptoms, physical examinations, laboratory findings, radiological findings, and progress of the patients were reviewed. Results During the four-year study period, a total of 82 female patients received a final diagnosis of FHCS in the ED. Chlamydia trachomatis was identified as a pathogen in 89% of the patients. Their clinical characteristics and laboratory findings were described. Fifty-two patients (63.4%) were admitted to the hospital. All of the admitted patients improved after treatment combining antibiotic therapy with conservative care. Conclusion FHCS should be considered as a differential diagnosis for female patients of childbearing age with right upper abdominal pain. Timely diagnosis using biphasic computed tomography (CT) with arterial and portal phases may help ensure adequate medical treatment as well as avoid invasive procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Features of Fitz-Hugh-Curtis Syndrome in the Emergency Department

et al. 2012

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“…In women with PID, perihepatitis associated with right upper abdominal pain is known as Fitz-HughCurtis syndrome (9,10). It has been demonstrated that hepatic capsular enhancement implying perihepatitis can be present in women with PID without right upper abdominal pain (9,11). This means that hepatic capsular enhancement can be one of the useful ancillary CT findings for diagnosis of acute PID, regardless of association with Fitz-Hugh-Curtis syndrome.…”

Section: Pelvic Inflammatory Diseasementioning

confidence: 98%

CT findings in acute peritonitis: a pattern-based approach

Filippone¹,

Cianci²,

Pizzi³

et al. 2015

Diagn Interv Radiol

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“…Capsular enhancement seen on early arterialphase images reflects increased blood flow or inflammation at the inflamed hepatic capsule [17]. In contrast, violin string-like adhehttp://jsms.sch.ac.kr sions are characteristics of the chronic phase of this disease while enhancement on delayed phase CT scan reflects early capsular fibrosis [18].…”

Section: Introductionmentioning

confidence: 99%

Clinical Significance of Hepatic Capsular Enhancement in Multi-Directional Computed Tomography with Fitz-Hugh-Curtis Syndrome

Yoo

Park

Lee

et al. 2019

Soonchunhyang Med Sci

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Fitz-Hugh-Curtis syndrome (FHCS) is characterized by perihepatitis in patients with pelvic inflammatory disease. Hepatic capsular enhancement in arterial phase of abdominal computed tomography (CT) is usually required for definite diagnosis. The objective of this study was to assess clinical significance of intensity of hepatic capsular enhancement in CT of patients with FHCS. Methods: A total of 86 patients who had hepatic capsular enhancement in CT due to FHCS were retrospectively enrolled. The hepatic capsular enhancement was divided into three patterns according to the intensity of enhancement by an expert radiologist: A, partial weak enhancement; B, partial strong or diffuse weak enhancement; and C, diffuse strong enhancement. Other clinical and laboratory parameters such as duration of admission were also evaluated. Results: Hepatic capsular enhancement in CT was classified into pattern A (n= 28), pattern B (n= 35), and pattern C (n= 23). Hospital stay was significantly shorter in pattern A (6.1± 2.4 days, P< 0.001) than that in pattern B (7.2± 2.9 days) or pattern C (7.7± 2.2 days). Subjective perihepatic pain duration was well correlated with the degree of hepatic capsular enhancement (P< 0.001). In multivariate analysis, the intensity of capsular enhancement was significantly associated with hospital stay after adjusting other factors. However, laboratory inflammation marker was not directly correlated with hepatic capsular enhancement. Conclusion: Enhancement pattern of CT scan in patients with FHCS is closely related to its clinical severity and the course of this disease.

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Perihepatitis with pelvic inflammatory disease (PID) on MDCT: characteristic findings and relevance to PID

Cited by 29 publications

References 24 publications

Clinical Features of Fitz-Hugh-Curtis Syndrome in the Emergency Department

Clinical Features of Fitz-Hugh-Curtis Syndrome in the Emergency Department

CT findings in acute peritonitis: a pattern-based approach

Clinical Significance of Hepatic Capsular Enhancement in Multi-Directional Computed Tomography with Fitz-Hugh-Curtis Syndrome

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