Clinical outcome of Fitz-Hugh-Curtis syndrome mimicking acute biliary disease

World J Gastroenterol. 2008 Dec 7;14(45):6975-80. doi: 10.3748/wjg.14.6975.

Abstract

Aim: To analyze the clinical characteristics of patients diagnosed with Fitz-Hugh-Curtis syndrome.

Methods: The clinical courses of patients that visited St. Mary's Hospital with abdominal pain from January 2005 to December 2006 and were diagnosed with Fitz-Hugh-Curtis syndrome were examined.

Results: Fitz-Hugh-Curtis syndrome was identified in 22 female patients of childbearing age; their mean age was 31.0+/-8.1 years. Fourteen of these cases presented with pain in the upper right abdomen alone or together with pain in the lower abdomen, and six patients presented with pain only in the lower abdomen. The first impression at the time of visit was acute cholecystitis or cholangitis in 10 patients and acute appendicitis or pelvic inflammatory disease in eight patients. Twenty-one patients were diagnosed by abdominal computer tomography (CT), and the results of abdominal sonography were normal for 10 of these patients. Chlamydia trichomatis was isolated from 18 patients. Two patients underwent laparoscopic adhesiotomy and 20 patients were completely cured by antibiotic treatment.

Conclusion: For women of childbearing age with acute pain in the upper right abdomen alone or together with pain in the lower abdomen, Fitz-Hugh-Curtis syndrome should be considered during differential diagnosis. Moreover, in cases suspected to be Fitz-Hugh-Curtis syndrome, abdominal CT, rather than abdominal sonography, assists in the diagnosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Pain / diagnosis*
  • Abdominal Pain / diagnostic imaging
  • Abdominal Pain / drug therapy
  • Acute Disease
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Antibodies, Bacterial / blood
  • Biliary Tract Diseases / diagnosis*
  • Biliary Tract Diseases / diagnostic imaging
  • Biliary Tract Diseases / drug therapy
  • Chlamydia Infections / blood
  • Chlamydia Infections / diagnosis
  • Chlamydia Infections / drug therapy
  • Chlamydia trachomatis / immunology
  • Diagnosis, Differential
  • Female
  • Humans
  • Inflammation / diagnosis*
  • Inflammation / diagnostic imaging
  • Inflammation / drug therapy
  • Middle Aged
  • Pelvic Pain / diagnosis*
  • Pelvic Pain / diagnostic imaging
  • Pelvic Pain / drug therapy
  • Retrospective Studies
  • Syndrome
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Antibodies, Bacterial