A Cause of Adhesions in the Right Upper Quadrant

Elderly Fitz-Hugh–Curtis syndrome observed with superb microvascular imaging system

“…However, laparoscopy performed for diagnosis of FHCS is a slightly invasive procedure. Some recent reports have noted that imaging examination findings obtained with contrast-enhanced computed tomography (CECT) were useful for diagnosing FHCS [1,2]. Here, we report successful observation of the microvascular structure in the inflamed portion between the abdominal wall and surface of the liver in an elderly patient with FHCS using a superb microvascular imaging (SMI) system, a new technology developed for observing lower vascular flow that cannot be observed by conventional color Doppler imaging.…”

“…observation as adhesions between the abdominal wall and surface of the liver, and then 4 years later Fitz-Hugh reported peri-hepatitis and salpingitis in association with gonococcal infection [1][2][3][4]. Later in 1982, Wolner-Hassen reported a case in which chlamydia infection caused FHCS [3].…”

“…Adhesions between the abdominal wall and surface of the liver following peri-inflammation of the liver sometimes cause right-side epigastric pain, with 'violin string sign' adhesions between the abdominal wall and liver surface a specific finding in a laparoscopic examination [1,2]. However, laparoscopy performed for diagnosis of FHCS is a slightly invasive procedure.…”

Fitz-Hugh-Curtis Syndrome as Finding during Open Cholecystectomy and Unknown Pregnancy: Clinical Case

“…These adhesions are formed between liver surface and the abdominal wall. Curtis in 1930 associates this training to the presence of Neisseria gonorrhoeae [2].…”

Right Upper Quadrant Pain in a Young Female

“…The FHC syndrome typically presents without or only faint involvement of the liver parenchyma. While Neisseria gonorrhoeae was the first established pathogen [1,2], Chlamydia trachomatis is incriminated in most cases nowadays [3]. The pathophysiology of perihepatitis FHC is unclear, but direct infection of the liver capsule, hematologic or lymphatic spread as well as an exaggerated immune response have been suggested [4].…”