Fitz-Hugh-Curtis syndrome

Fitz-Hugh-Curtis syndrome is a rare complication of pelvic inflammatory disease (PID) named after the two physicians, Fitz-Hugh and Curtis who first reported this condition in 1934 and 1930 respectively.

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Fitz-Hugh-Curtis syndrome is usually caused by gonorrhoea (acute gonococcal perihepatitis) or chlamydia bacteria, which cause a thinning of cervical mucous and allow bacteria from the vagina into the uterus and oviducts, causing infection and inflammation. Occasionally, this inflammation can affect Glisson's capsule, a thin layer of connective tissue surrounding the liver.

The signs are an acute onset, upper right-quadrant abdominal pain and tenderness aggravated by breathing, coughing or movement, and referred to the right shoulder following an episode of PID. Laparoscopy may reveal "violin string" adhesions.

Treatment involves diagnosing and treating the underlying cause correctly. The adhesions can be cut laparoscopically.

References

• Curtis AH. A cause of adhesion in the right upper quadrant. JAMA 1930;94:1221-122.
• Fitz-Hugh Jr T. Acute gonococcic peritonitis of the right upper quadrant in women. J Am Med Assoc 1934;102:2094-2096.