Adhesions of the Anterior Surface of the Liver

Curtis, Arthur H.

doi:10.1001/jama.1932.02740760020006

Cited by 11 publications

(5 citation statements)

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“…Traditionally, inflammation of the liver capsule has been attributed to direct bacterial infection. 4 Organisms were thought to travel from the genital area via the fallopian tubes and the paracolic gutters to the liver capsule. 4,15 Some evidence supports this: Holm-Nielsen et al 16 demonstrated that peritoneal fluid is propelled from the pelvis to the diaphragm, where it is preferentially absorbed on the right side.…”

Section: Direct Infection Of the Liver?mentioning

confidence: 99%

“…4 Organisms were thought to travel from the genital area via the fallopian tubes and the paracolic gutters to the liver capsule. 4,15 Some evidence supports this: Holm-Nielsen et al 16 demonstrated that peritoneal fluid is propelled from the pelvis to the diaphragm, where it is preferentially absorbed on the right side. The association between recent insertion of an IUD and Fitz-Hugh-Curtis syndrome 13 also supports the hypothesis of intraperitoneal spread of organisms.…”

Section: Direct Infection Of the Liver?mentioning

confidence: 99%

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Fitz-Hugh-Curtis syndrome: a diagnosis to consider in women with right upper quadrant pain.

Peter

Jaeger

2004

Cleveland Clinic Journal of Medicine

123

107

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ITZ-HUGH-CURTIS SYNDROME-perihepatitis associated with pelvic inflammatory disease-can pose a diagnostic challenge to the clinician, especially when right upper quadrant pain predominates, mimicking acute gall bladder disease. This article reviews the etiology, pathogenesis, diagnosis, and treatment of this syndrome. s HISTORICAL PERSPECTIVE Association with gonorrhea Fitz-Hugh-Curtis syndrome was first described in 1920 by Carlos Stajano, 1 who noted adhesions between the liver capsule and anterior abdominal wall in patients with gonococcal infection and right upper quadrant pain. In the 1930s Thomas Fitz-Hugh and Arthur Curtis also described the syndrome and made the connection between the acute clinical syndrome of right upper quadrant pain following a pelvic infection and the "violinstring" adhesions found in women with evidence of prior salpingitis. 2,3 Curtis described several cases of these very typical adhesions between the liver and the abdominal wall in patients with gonococcal disease and noted that similar adhesions were not found in other causes of peritonitis, suggesting the combination was a unique syndrome. 4 Fitz-Hugh suggested that Neisseria gonorrhoeae was the cause when he found gram-negative diplococci on smears from the liver capsule in patients with the syndrome. 2 Since then, the diagnosis of Fitz-Hugh-Curtis syndrome has largely been a clinical

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Section: Direct Infection Of the Liver?mentioning

confidence: 99%

Section: Direct Infection Of the Liver?mentioning

confidence: 99%

Fitz-Hugh-Curtis syndrome: a diagnosis to consider in women with right upper quadrant pain.

Peter

Jaeger

2004

Cleveland Clinic Journal of Medicine

123

107

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“…Post-surgery adhesion in the liver poses a significant concern for patients undergoing various procedures such as partial liver resections [1,2], liver transplantation [3,4], abdominal surgery for gonorrheal disease [5], gastrectomy [6], and splenectomy [7]. This issue inflicts suffering on patients and presents complications for surgeons during reoperation procedures, contributing to increased blood loss and extended operation times [8,9].…”

Section: Introductionmentioning

confidence: 99%

Investigation of anti-adhesion ability of 8-arm PEGNHS-modified porcine pericardium

Say,

Suzuki,

Hashimoto

et al. 2024

Biomed. Mater.

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In post-adhesion surgery, there is a clinical need for anti-adhesion membranes specifically designed for the liver, given the limited efficacy of current commercial products. To address this demand, we present a membrane suitable for liver surgery applications, fabricated through the modification of decellularized porcine pericardium with 20 KDa 8-arm PEGNHS. We also developed an optimized modification procedure to produce a high-performance anti-adhesion barrier. The modified membrane significantly inhibited fibroblast cell adherence while maintaining minimal levels of inflammation. By optimizing the modification ratio, we successfully controlled post-adhesion formation. Notably, the 8-arm PEG-modified pericardium with a molar ratio of 5 exhibited the ability to effectively prevent post-adhesion formation on the liver compared to both the control and Seprafilm®, with a low adhesion score of 0.5 out of 3.0. Histological analysis further confirmed its potential for easy separation. Furthermore, the membrane demonstrated regenerative capabilities, as evidenced by the proliferation of mesothelial cells on its surface, endowing anti-adhesion properties between the abdominal wall and liver. These findings highlight the membrane’s potential as a reliable barrier for repeated liver resection procedures that require the removal of the membrane multiple times.

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“…1) present in women with signs of prior salpingitis [3,4]. After having studied several cases of patients with gonococcal disease, baring these adhesions between the liver and the abdominal wall, Curtis demonstrated a couple of years later that these signs are absent in other cases of peritonitis, thus making this entity a unique syndrome [5]. Also, Fitz-Hugh demonstrated that N. gonorrhoeae should be the pathogenetic cause of the syndrome, after having isolated gram-negative diplococci on liver capsule smears [4].…”

Section: Introductionmentioning

confidence: 99%

Fitz-Hugh–Curtis syndrome

Theofanakis

Kyriakidis

2010

Gynecol Surg

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Fitz-Hugh-Curtis syndrome is characterized by perihepatic inflammation appearing with pelvic inflammatory disease (PID), mostly in women of childbearing age. Acute pain and tenderness in the right upper abdomen is the most common symptom that makes women visit the emergency rooms. It can also emerge with fever, nausea, vomiting, and, in fewer cases, pain in the left upper abdomen. It seems that the pathogens that are mostly responsible for this situation is Chlamydia trachomatis and Neisseria gonorrhoeae. Because of its characteristics, differential diagnosis for this syndrome is a constant, as it mimics many known diseases, such as cholelithiasis, cholecystitis, and pulmonary embolism. The development of CT scanning provided diagnosticians with a very useful tool in the process of recognizing and analyzing the syndrome. Nevertheless, the only secure diagnostic method is the laparoscopic evaluation of the abdomen and the spotting of the unique "violin-string" adhesions between the liver and the abdominal wall or the diaphragm. Though it is a difficult diagnosis, the syndrome and, therefore, the PID that caused its outburst are usually easily treated with courses of antibiotics, as monotherapy or combined, with satisfactory results.

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Adhesions of the Anterior Surface of the Liver

Cited by 11 publications

References 1 publication

Fitz-Hugh-Curtis syndrome: a diagnosis to consider in women with right upper quadrant pain.

Fitz-Hugh-Curtis syndrome: a diagnosis to consider in women with right upper quadrant pain.

Investigation of anti-adhesion ability of 8-arm PEGNHS-modified porcine pericardium

Fitz-Hugh–Curtis syndrome

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