Intérêt du scanner avec injection dans le syndrome de Fitz-Hugh-Curtis

Pediatric fitz-hugh-curtis syndrome diagnosed by magnetic resonance imaging

A 17-year-old girl, who had a sexual intercourse history, presented with fever and right upper quadrant pain. On physical examination, tenderness and percussion tender were identified at that quadrant point, but cervical motion tenderness was not identified. Plane X-ray, abdominal ultrasonography, and nonenhanced abdominal computed tomography, because of contrast agent allergy, showed no specific findings. Nonenhanced magnetic resonance imaging (MRI) demonstrated the high-intensity area in the surface and subcapsule of the liver. From vaginal discharge, polymerase chain reaction for Chlamydia trachomatis was positive. Considered physical and MRI findings, Fitz-Hugh-Curtis syndrome was diagnosed. After Azithromycin administering (1000 mg/day), she got better and discharged.

A case report with Fitz-Hugh-Curtis syndrome, what does it mean?

Fitz-Hugh-Curtis (FHC) syndrome, also known as acute perihepatitis, was discovered in 1930 and is a rare disorder characterised by inflammation of the peritoneum and the tissues surrounding the liver. This syndrome can arise as a potential complication from a pelvic inflammatory disease caused by Neisseria gonorrhoeae or Chlamydia trachomatis. This syndrome is not well known in the medical community and is often underdiagnosed. In this case report, we revisit FHC syndrome, particularly its noninvasive diagnosis and complications.

Fitz-Hugh-Curtis syndrome: clinical diagnostic value of dynamic enhanced MSCT

[Purpose] This study aimed to investigate the clinical diagnostic value of dynamic enhanced multislice computed tomography (MSCT) for Fitz-Hugh-Curtis syndrome (FHCS). [Subjects and Methods] This study retrospectively analyzed the clinical features and manifestations of scanning and dynamic enhanced MSCT in 19 patients with FHCS. [Results] MSCT scans showed different degrees of liver capsule thickness in the lesion area: seven cases of sub-capsular effusion and three cases with a small amount of pleural effusion; thickness of the liver capsular arterial phase showing significant enhancement in 17 cases, and slight enhancement in two; portal venous and delayed phase enhancement decreased with no clear boundary of the liver parenchyma; and adjacent hepatic parenchymal involvement in five cases, in which the arterial phase appeared to have patchy or triangular enhancement, and unclear portal vein and delayed phase imaging findings. MSCT revealed pelvic inflammatory disease in 14 cases, peritonitis in two, endometritis combined with bilateral ovarian abscesses in two, and a tube-ovarian abscess in one. [Conclusion] Dynamic enhanced MSCT can accurately display liver capsule lesions and possible pelvic inflammatory diseases related to FHCS, suggest the infection source, and have high application value for making early, accurate diagnoses and improved prognosis.