Difference between revisions of "Fitz-Hugh-Curtis syndrome"

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[[File:Perihepatic adhesions 2.jpg|thumbnail|"Violin string sign", adhesions between the liver and abdominal wall.]]
 
[[File:Perihepatic adhesions 2.jpg|thumbnail|"Violin string sign", adhesions between the liver and abdominal wall.]]
 
*A complication of [[Pelvic Inflammatory Disease]], involving acute [[gonococcal]] or [[chlamydia]] trachomatis peritonitis of the right upper quadrant in women
 
*A complication of [[Pelvic Inflammatory Disease]], involving acute [[gonococcal]] or [[chlamydia]] trachomatis peritonitis of the right upper quadrant in women
*Pain is caused by liver capsule inflammation
+
*Pain is caused by liver capsule inflammation leading to the creation of adhesions
  
 
==Clinical Features<ref name="multiple">Livengood et al. Clinical features and diagnosis of pelvic inflammatory disease. Uptodate.</ref>==
 
==Clinical Features<ref name="multiple">Livengood et al. Clinical features and diagnosis of pelvic inflammatory disease. Uptodate.</ref>==
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{{DDX RUQ}}
 
{{DDX RUQ}}
  
==Diagnosis==
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==Evaluation==
 +
[[File:PMC4499951 jpts-27-1641-g003.png|thumb|CT abdomen (A–D = portal venous phase): A. Homogeneously thickened strip of enhancement (black arrow); B. Lesion in the right paracolic gutter area without exact anomaly density; C. Pelvic fat spaces with increased density, inhomogeneous enhancement, and visible rectal effusion (cross); D. Bilateral ovarian abscess (white arrow) and surrounding uterus effusion.]]
 
*Aminotransferases usually normal or mildly elevated <ref name="multiple">Livengood et al. Clinical features and diagnosis of pelvic inflammatory disease. Uptodate.</ref>
 
*Aminotransferases usually normal or mildly elevated <ref name="multiple">Livengood et al. Clinical features and diagnosis of pelvic inflammatory disease. Uptodate.</ref>
 
**Generally not markedly elevated <ref>Curtis AH. A cause of adhesion in the right upper quadrant.JAMA. 1930;94(16):1221-1222. doi:10.1001/jama.1930.02710420033012.</ref><ref>Peter, N. G.; Clark, L. R.; Jaeger, J. R. (2004). "Fitz-Hugh-Curtis syndrome: a diagnosis to consider in women with right upper quadrant pain". Cleveland Clinic journal of medicine 71 (3): 233–239. doi:10.3949/ccjm.71.3.233. PMID 15055246</ref>
 
**Generally not markedly elevated <ref>Curtis AH. A cause of adhesion in the right upper quadrant.JAMA. 1930;94(16):1221-1222. doi:10.1001/jama.1930.02710420033012.</ref><ref>Peter, N. G.; Clark, L. R.; Jaeger, J. R. (2004). "Fitz-Hugh-Curtis syndrome: a diagnosis to consider in women with right upper quadrant pain". Cleveland Clinic journal of medicine 71 (3): 233–239. doi:10.3949/ccjm.71.3.233. PMID 15055246</ref>
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==Disposition==
 
==Disposition==
 +
*Admission criteria same for [[PID]]
 +
**Pregnancy
 +
**Toxic, systemic symptoms
 +
**Poor compliance
 +
**Failure of outpatient therapy
 +
**[[Tubo-ovarian abscess]]
 +
 +
==See Also==
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*[[PID]]
  
 
==References==
 
==References==
 
<references/>
 
<references/>
  
[[Category:OB/GYN]]
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[[Category:OBGYN]]

Latest revision as of 16:13, 6 October 2021

Background

"Violin string sign", adhesions between the liver and abdominal wall.

Clinical Features[1]

Differential Diagnosis

RUQ Pain

Evaluation

CT abdomen (A–D = portal venous phase): A. Homogeneously thickened strip of enhancement (black arrow); B. Lesion in the right paracolic gutter area without exact anomaly density; C. Pelvic fat spaces with increased density, inhomogeneous enhancement, and visible rectal effusion (cross); D. Bilateral ovarian abscess (white arrow) and surrounding uterus effusion.
  • Aminotransferases usually normal or mildly elevated [1]
    • Generally not markedly elevated [2][3]
  • If CT obtained, may show inflammatory changes in pelvic and perihepatic regions
  • Ultimately a diagnosis of exclusion with supporting evidence of gonorrhea or chlamydia

Management

Disposition

  • Admission criteria same for PID
    • Pregnancy
    • Toxic, systemic symptoms
    • Poor compliance
    • Failure of outpatient therapy
    • Tubo-ovarian abscess

See Also

References

  1. 1.0 1.1 Livengood et al. Clinical features and diagnosis of pelvic inflammatory disease. Uptodate.
  2. Curtis AH. A cause of adhesion in the right upper quadrant.JAMA. 1930;94(16):1221-1222. doi:10.1001/jama.1930.02710420033012.
  3. Peter, N. G.; Clark, L. R.; Jaeger, J. R. (2004). "Fitz-Hugh-Curtis syndrome: a diagnosis to consider in women with right upper quadrant pain". Cleveland Clinic journal of medicine 71 (3): 233–239. doi:10.3949/ccjm.71.3.233. PMID 15055246