Fitz-Hugh-Curtis syndrome. A laparoscopic approach

Area of Science:

• Gastroenterology
• Hepatology
• Infectious Diseases

Background:

• Fitz-Hugh-Curtis syndrome is a complication of pelvic inflammatory disease, characterized by perihepatic inflammation.
• Patients often present with persistent right upper quadrant pain, mimicking other hepatobiliary conditions.
• Standard antibiotic therapy may fail to resolve the characteristic symptoms.

Observation:

• Four patients with classical Fitz-Hugh-Curtis syndrome experienced persistent right upper quadrant pain.
• Extensive medical evaluations and antibiotic treatments were ineffective in alleviating their symptoms.
• Laparoscopy was employed for diagnostic and therapeutic purposes in these challenging cases.

Findings:

• Laparoscopy provided an ideal method for definitive diagnosis of Fitz-Hugh-Curtis syndrome.
• Typical perihepatic 'violin-string' adhesions were visualized during laparoscopy.
• Cauterization and division of adhesions under direct vision led to dramatic symptom resolution.

Implications:

• Laparoscopy is a valuable tool for diagnosing and treating Fitz-Hugh-Curtis syndrome when conservative measures fail.
• Effective management of perihepatic adhesions can significantly improve patient outcomes.
• This approach highlights the importance of considering laparoscopic intervention for refractory right upper quadrant pain potentially linked to Fitz-Hugh-Curtis syndrome.