Fitz-Hugh-Curtis syndrome is characterized by inflammation in perihepatic capsules with concomitant pelvic inflammation. The pain in the right upper abdomen appeared as the main symptom. These cases have to be cautiously differentiated from diseases for which the major symptom is pain in the right upper abdomen Fitz-Hugh-Curtis syndrome has been classified as a benign disease that can be diagnosed by non-invasive methoids and treated readily by antibiotic therapy. Nevertheless, without sufficient understanding of this disease, it could be misdiagnosed as other acute diseases with similar clinical symptoms, and thus patients may undergo unnecessary treatment or tests.
A research article to be published on December 7, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Jin Il Kim from the Catholic University of Korea analyzed the clinical characteristics of patients diagnosed with Fitz-Hugh-Curtis syndrome.
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 6 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 a pelvic inflammatory disease in 8 patients. Twenty-one patients were diagnosed by abdominal CT, and the results of abdominal sonography were normal for 10 of the patients. C. trichomatis was isolated from 18 patients, and except 2 patients performed laparoscopic adhesiotomy, 20 patients were completely cured by antibiotics treatment.
They concluded that for childbearing-age women with acute pain in the upper right abdomen alone or together with pain in the lower abdomen and that have normal liver function test results, Fitz-Hugh-Curtis syndrome should be differentiated-diagnosed. Moreover, for the cases suspected to be Fitz-Hugh-Curtis syndrome, abdominal CT, rather than abdominal sonography, assists in the diagnosis.
Reference: Woo SY, Kim JI, Cheung DY, Cho SH, Park SH, Han JY, Kim JK. Clinical outcome of Fitz-Hugh-Curtis syndrome mimicking acute biliary disease. World J Gastroenterol 2008; 14(45): 6975-6980 http://www.wjgnet.com/1007-9327/14/6975.asp
Correspondence to: Jin Il Kim, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, the Catholic University of Korea, #62, St. Mary's Hospital, Yeouido-dong, Yeongdeungpo-gu, Seoul 150-713, South Korea. jikim@catholic.ac.kr Telephone: +82-2-37791328 Fax: +82-2-37791331
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World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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