Perihepatitis in pelvic inflammatory disease--association with intrauterine contraception

The Fitz-Hugh-Curtis syndrome (FHCS), or perihepatitis as a complication of pelvic inflammatory disease (PID), is readily diagnosed by laparoscopy. Among 274 non-selected cases of acute PID verified laparoscopically, FHCS was found in 38 (13.8 per cent). Twenty-four of the patients presented right-upper-quadrant pain and tenderness, while 14 experienced no local symptoms. Perihepatitis was found in a slightly higher frequency in PID cases of low age and in those using intrauterine contraception (IUCD) but the differences lack statistical significance. However, acute PID occurring within 6 weeks after IUCD insertion was associated significantly more often with FHCS (p less than 0.01). It is suggested that the traumatizing effect of IUCD insertion facilitates the spread of pelvic inflammatory material to the perihepatic region.