The gold standard for diagnosis of Fitz-Hugh–Curtis syndrome, though rarely required, is laparoscopy with direct visualization of the characteristic "violin string adhesions" along with liver capsule scarring and inflammation. Antibody testing of 57-kDa chlamydial heat-shock protein can be done in cases where all other tests have been non ...

Fitz-Hugh–Curtis syndrome (FHCS) is defined by the sign of perihepatic (violin-string) adhesions extending from the parietal peritoneum of the anterior abdominal wall to the anterior liver (Glisson) capsule and symptoms of right upper quadrant abdominal pain as well as those, most commonly, referable to a pelvic inflammatory disease (PID ...

Jul 3, 2023 · A final diagnosis can be made through laparoscopy or laparotomy via direct visualization of violin string-like adhesions or through hepatic capsular biopsy and culture. Fitz-Hugh-Curtis syndrome (FHCS), or perihepatitis, is a chronic manifestation of pelvic inflammatory disease (PID).[1]

May 24, 2024 · Fitz-Hugh-Curtis syndrome refers to perihepatitic adhesions between the liver capsule and under surface of the anterior abdominal wall seen on laparotomy/laparoscopy.

Mar 12, 2012 · In the 1930's Thomas Fitz–Hugh and Arthur Curtis also described the syndrome and made a connection between right upper quadrant pain following a pelvic infection and violin – string like perihepatic adhesions.

Patients commonly present with pleuritic right upper quadrant pain. 1 Imaging results are often normal; however, perihepatic “violin string” adhesions may be observed on both ultrasonography and CT. CT may also show fluid and fat stranding extending from the pelvis to the right upper quadrant, as well as liver capsule enhancement.3,4.

"Fitz-Hugh-Curtis" (FHC) syndrome, also known as acute perihepatitis, typically presents with "violin-string" adhesions between the liver and the anterior abdominal wall or the diaphragm , most commonly as a result of chlamydial or gonococcal infections .

The perihepatic friction rubs were not heard in our patients, because the acute stage had progressed to the chronic, fibrinous perihepatitis with the very thin adhe- sions, the so-called ‘violin-strings’ [3]. Moreover, the ascites made it impossible to use friction rub sign.

Laparoscopy was the key to the diagnosis, revealing the violin-string-like perihepatic adhesions typical of this syndrome. Lysis of the adhesions resolved the patients' symptoms of persistent severe abdominal pain.

During laparoscopic left colectomy, we found adhesions between the anterior surface of the liver and the abdominal wall violin-string like perihepatic adhesions as Fitz-Hugh-Curtis syndrome that justified the right upper quadrant pain too.