High prevalence of Fitz–Hugh–Curtis Syndrome in genital tuberculosis

Abstract

Perihepatitis with violin string adhesions between the liver and the anterior abdominal wall in association with gonococcal or chlamydial salpingitis constitutes Fitz-Hugh-Curtis Syndrome (FHCS). It manifests as pain and tenderness in the right upper quadrant of abdomen pleuritic pain exacerbated by breathing coughing laughing and movement probably due to irritation of Glissons capsule of the liver. There are two phases of the syndrome; acute and chronic. In the acute phase perihepatitis and focal peritonitis result from the transport of inflammatory peritoneal fluid either directly or by lymphatic vessels to the subphrenic and subdiaphragmatic spaces. In the chronic phase violin string adhesions are observed between the anterior surface of the liver and the anterior abdominal wall. Recently genital and abdominal tuberculosis has been observed to be associated with FHCS in a report of three cases. From June 2004 to December 2006 a total of 82 women were found to have genital tuberculosis.The ages ranged between 19 to 46 years (mean age 25.6 years). Most women were from rural areas (n=60 75.6%) with the majority of poor or low socioeconomic status (n=72 87.8%). (excerpt)