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Mechanical partial small bowel obstruction in a patient with Fitz-Hugh-Curtis syndrome
O R Abul-Khoudoud1, A Y Khabbaz, C H Butcher
1Department of Surgery, Union Memorial Hospital, Baltimore, Maryland, USA. souadoak@prodigy.net
Abstract:
Perihepatitis or Fitz-Hugh-Curtis syndrome is a complication of pelvic inflammatory disease that usually leaves characteristic violin string adhesions on the anterior liver surface. These adhesions are common incidental findings on subsequent laparoscopy or laparotomy and are considered benign. We present a case of partial mechanical small bowel obstruction as a sequel of this syndrome that was diagnosed and treated laparoscopically.
Insights
Fitz-Hugh-Curtis syndrome, a complication of pelvic inflammatory disease, can cause liver adhesions. This case highlights a rare instance where these adhesions led to small bowel obstruction, successfully treated with laparoscopy.
Area of Science:
- Hepatology
- Gastroenterology
- Pelvic Inflammatory Disease
Background:
- Perihepatitis, also known as Fitz-Hugh-Curtis syndrome, is a known complication of pelvic inflammatory disease.
- It typically results in the formation of adhesions on the anterior liver surface, often described as 'violin string' adhesions.
- These adhesions are frequently discovered incidentally during abdominal surgeries and are generally considered benign.
Observation:
- This report details a unique case of partial mechanical small bowel obstruction.
- The obstruction was identified as a sequela of Fitz-Hugh-Curtis syndrome.
- The patient's condition presented as a complication stemming from the liver capsule adhesions.
Findings:
- The study successfully diagnosed a rare complication of Fitz-Hugh-Curtis syndrome.
- The findings confirm that liver capsule adhesions can lead to significant gastrointestinal issues, specifically small bowel obstruction.
- Laparoscopic intervention proved effective in managing this complication.
Implications:
- This case broadens the understanding of potential complications associated with Fitz-Hugh-Curtis syndrome beyond typical presentations.
- It underscores the importance of considering intra-abdominal adhesions in the differential diagnosis of small bowel obstruction, even in the absence of acute pelvic inflammatory disease.
- Laparoscopic surgery offers a minimally invasive approach for treating mechanical small bowel obstruction secondary to perihepatitis adhesions.