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Fitz-Hugh-Curtis syndrome
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  1. Kiyoshi Shikino and
  2. Masatomi Ikusaka
  1. Department of General Medicine, Chiba University Hospital, Chiba, Japan
  1. Correspondence to Dr Kiyoshi Shikino, kshikino{at}gmail.com

https://doi.org/10.1136/bcr-2019-229326

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    Description

    A 29-year-old woman presented with 2 days of right upper abdominal pain. The pain worsened with deep breathing and body movements, which radiated to the right shoulder. Physical examination revealed tenderness on palpation of the right upper abdomen and tenderness to percussion of the lower ribs. Endocervical culture revealed Chlamydia trachomatis. Abdominal contrast-enhanced CT showed conspicuous increased perihepatic enhancement on the right lobe of the liver (figures 1 and 2). Fitz-Hugh-Curtis syndrome was diagnosed, which improved after azithromycin was administered.

    Figure 1
    Figure 1

    Contrast-enhanced CT (axial) showed conspicuous increased perihepatic enhancement on the right lobe of the liver (arrows).

    Figure 2
    Figure 2

    Contrast-enhanced CT (coronal) showed conspicuous increased perihepatic enhancement on the right lobe of the liver (arrows).

    Fitz-Hugh-Curtis syndrome is considered a rare complication of pelvic inflammatory disease, mostly associated with C. trachomatis. The right upper abdominal pain appears as the main symptom and becomes more severe in response to deep breathing and body movements. Occasionally, the pain may radiate to the right shoulder. The increased enhancement along the hepatic surface on CT has been described as a finding that can suggest the diagnosis of Fitz-Hugh-Curtis syndrome.1

    Learning points

    • Fitz-Hugh-Curtis syndrome present right upper abdominal pain worsened with deep breathing and body movements.

    • The increased enhancement along the hepatic surface on CT is a characteristic finding of Fitz-Hugh-Curtis syndrome.

    Reference

    1. ↵
      2. Nishie A ,
      3. Yoshimitsu K ,
      4. Irie H , et al
      . Fitz-Hugh-Curtis syndrome. radiologic manifestation. J Comput Assist Tomogr 2003;27:786–91.
      OpenUrlCrossRefPubMed

    Footnotes

    • Patient consent for publication Not required.

    • Contributors KS managed patient. KS wrote the draft. MI revised this article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.