Korean J Obstet Gynecol.  2011 Jan;54(1):43-48. 10.5468/KJOG.2011.54.1.43.

Clinical features of Fitz-Hugh-Curtis syndrome diagnosed by abdomino-pelvic computed tomography

• Shin SH
• Kim YA
• Chang DY
• Jun KC
• Jeon MK
• Kim KA

• KMID: 2274021
• DOI: http://doi.org/10.5468/KJOG.2011.54.1.43

Abstract

OBJECTIVE
To analyze the clinical characteristics in patients of Fitz-Hugh-Curtis syndrome diagnosed by abdomino-pelvic computed tomography (CT).
METHODS
We retrospectively examined the clinical courses of 62 patients who visited with abdominal pain from March 2005 to July 2010. The clinical manifestations, physical examination, laboratory manifestations, CT findings, treatments, and prognosis were analyzed.
RESULTS
The mean age of the patients ranged from 13 to 48 years and their average age was 28.56+/-8.77. Twenty-eight of them (45.2%) were married but all the subjects had sexual experience. The chief complaints requiring a visit to the hospital were abdominal pain (74.2%), vaginal discharge (19.4%), nausea and vomiting (3.2%), and fever (1.6%). On physical examination, location of tenderness was right upper-quadrant tenderness (41.9%), whole abdomen (37.1%), right lower-quadrant (24.2%), lower abdomen (16.1%), and epigastric area (6.5%). The isolation of bacterial pathogens was found in 26% (13/62) of them. Polymerase chain reaction tests for Chlamydia trachomatis were positive in 34 patients (70.3%). All 62 cases showed liver capsular enhancement on CT in the early arterial phase. Peritoneal thickening (24.2%) and fluid collection (27.4%) were observed in the perihepatic area. Of 56 patients, 49 patients (87.5%) improved following antibiotic therapy and conservative care. Seven patients did not respond to antibiotic therapy, their symptoms improved after laparoscopic surgery.
CONCLUSION
For women of reproductive age with acute pain in the upper right abdominal alone or together with pain in the lower abdomen, Fitz-Hugh-Curtis syndrome should be suggested during examination. Moreover, in cases suspected to be Fitz-Hugh-Curtis syndrome, gynecologic examination, abdomino-pelvic CT, and tests for C. trachomatis could provide a more rapid and accurate diagnosis. Also, education and continuous follow up after therapy would be needed.

Keyword

Fitz-Hugh-Curtis syndrome; Abdomino-pelvic computed tomography; Chlamydia trachomatis

MeSH Terms

Abdomen
Abdominal Pain
Acute Pain
Chlamydia Infections
Chlamydia trachomatis
Female
Fever
Follow-Up Studies
Hepatitis
Humans
Liver
Nausea
Pelvic Inflammatory Disease
Peritonitis
Physical Examination
Polymerase Chain Reaction
Prognosis
Retrospective Studies
Vaginal Discharge
Vomiting
Chlamydia Infections
Hepatitis
Pelvic Inflammatory Disease
Peritonitis

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