Fitz-Hugh–Curtis syndrome (FHCS) is defined by the sign of perihepatic (violin-string) adhesions extending from the parietal peritoneum of the anterior abdominal wall to the anterior liver (Glisson) capsule and symptoms of right upper quadrant abdominal pain as well as those, most commonly, referable to a pelvic inflammatory disease (PID) process.
Outpatient treatment for Fitz-Hugh-Curtis syndrome is similar to that for PID: ceftriaxone, 250 mg IM once, and doxycycline, 100 mg PO twice daily for 14 days, with or without metronidazole, 500 mg PO twice daily for 14 days. Patients who are hemodynamically stable may be discharged home with OBGYN f/u.
Fitz-Hugh-Curtis syndrome (FHCS) is known as the great mimicker of acute cholecystitis; therefore, often times this diagnosis may be missed. In patients with pelvic inflammatory disease (PID),
Fitz-Hugh–Curtis syndrome is defined as perihepatitis associated with pelvic inflammatory disease. Chlamydia trachomatis is one of its most common aetiologies. This syndrome usually presents with right upper quadrant abdominal pain mimicking other hepatobiliary and gastrointestinal pathologies, hence, posing a diagnostic dilemma in settings with limited diagnostic tools.
Fitz-Hugh Curtis syndrome (FHCS) is a rare sequela of pelvic inflammatory disease that must be included on the differential in patients with abdominal pain, particularly if they have risk factors for sexually transmitted infections.
Laparoscopy is the criterion standard for diagnosis of pelvic inflammatory disease. Fitz-Hugh-Curtis syndrome is a complication of approximately 25% of patients with pelvic inflammatory disease, characterized by “violin-string” perihepatic inflammation. Treatment with cefoxitin, doxycycline, and metronidazole led to resolution within 2 weeks.
Fitz-Hugh-Curtis syndrome—inflammation of the liver capsule associated with genital tract infection—occurs in up to one fourth of patients with pelvic inflammatory disease (PID). Classically presenting as sharp, pleuritic right upper quadrant pain, usually but not always accompanied by signs of salpingitis, it can mimic many other common disorders such as cholecystitis and pyelonephritis.
FHCS is an uncommon condition of the perihepatic capsule
inflammation secondary to PID . The mechanism of the
inflammation is thought to result from the direct intraperitoneal
spread of infection towards the perihepatic region from initial
FHCS usually presents with RUQ abdominal pain that mimics hepatobiliary etiologies, and usually is associated with symptoms of PID including pelvic/lower abdominal pain, vaginal discharge or CMT.
Fitz-Hugh-Curtis syndrome is not well known, but it is classified as an emergent condition by the Model of the Clinical Practice of Emergency Medicine.
The condition most commonly (but not exclusively) occurs in females with pelvic inflammatory disease/salpingitis infected with Chlamydia trachomatis or Neisseria gonorrhoeae the commonly defined causative organisms.
FHCS is localized inflammation of the peritoneum associated with an ascending genital infection[1-3]. Typical lesions are the so-called ‘violin string adhesions’, which are peritoneal adhesions between the diaphragm’s right dome and the anterior surface of the liver capsule[4-3]. The liver itself is not involved, hence the term ‘perihepatitis’. This condition is considered to be a complication of PID and sometimes may be its only sign.
Fitz-Hugh-Curtis syndrome is a rare disorder that occurs almost exclusively in women. It is characterized by inflammation of the membrane lining the stomach (peritoneum) and the tissues surrounding the liver (perihepatitis).
The classic manifestation of perihepatitis, or Fitz-Hugh–Curtis syndrome, is severe right upper abdominal pain that often radiates to the shoulder. Concurrent left upper abdominal pain also may be present. Lower abdominal pain and evidence of acute or subacute PID are frequent findings.
Fitz-Hugh-Curtis syndrome (FHCS), or perihepatitis, is a chronic manifestation of pelvic inflammatory disease (PID). It is described as an inflammation of the liver capsule, without the involvement of the liver parenchyma, with adhesion formation accompanied by right upper quadrant pain.