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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three case histories of patients who were treated for gonococcal perihepatitis (Fitz-Hugh-Curtis syndrome) are reviewed. The incidence rate of this disease process is believed to be increasing, and a surgical consultation is often asked for in the evaluation of these individuals. The diagnosis of FHCS requires a high index of suspicion. However, if a patient has signs and symptoms of acute cholecystitis plus the recent onset of a purulent genitourinary infection, the diagnosis of FHCS is suggested. Confirmation of this diagnosis is obtained with the culturing of N. gonorrheae from urethral or cervical secretions. The clinical presentation may vary from a moderately symptomatic to an acutely ill individual. Most commonly there is an abrupt onset of sharp right upper quadrant pain. The finding of any degree of lower abdominal or pelvic tenderness in addition to the upper abdominal pain, should make one highly suspicious of pelvic inflammatory disease and concommitant FHCS. Although no deaths have been reported from this syndrome, it is important to make a prompt clinical diagnosis and commence appropriate antibiotic therapy. The currently recommended therapeutic regimen is procaine penicillin, 1,200,000 U, twice a day for 10 days.
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PMID:Gonococcal perihepatitis (the Fitz-Hugh-Curtis syndrome): a diagnostic dilemma. 45 27

Two women were admitted for increasing abdominal pain, vaginal discharge, and severe or moderate chronic ascites. Diffuse peritonitis without evidence of liver disease was found in both cases, and in one the ascites and vaginal discharge contained Chlamydia trachomatis. Both patients responded to doxycycline, and this and the laboratory findings pointed strongly to C trachomatis as the aetiological agent. C trachomatis may cause severe peritoneal infections with chronic ascites formation in the absence of liver disease in women with the Fitz-Hugh-Curtis syndrome. Prompt diagnosis and antibiotics lead to rapid cure.
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PMID:Diffuse peritonitis and chronic ascites due to infection with Chlamydia trachomatis in patients without liver disease: new presentation of the Fitz-Hugh-Curtis syndrome. 308

We encountered seven female adolescents with the Fitz-Hugh-Curtis syndrome and no signs or symptoms of salpingitis. Six of the patients had cervical cultures positive for Chlamydia trachomatis. The Fitz-Hugh-Curtis syndrome should be included in the differential diagnosis of right-sided abdominal pain in the sexually active female adolescent to avoid unnecessary diagnostic procedures and to reduce the prevalence of chlamydial infection and its complications.
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PMID:Chlamydia trachomatis Fitz-Hugh-Curtis syndrome without salpingitis in female adolescents. 341 33

The Fitz-Hugh-Curtis syndrome consists of right upper quadrant abdominal pain, perihepatitis and genital tract infection. Neisseria gonorrhoeae and Chlamydia trachomatis have been identified as causative agents. This syndrome frequently mimics other diseases and typically occurs in sexually active young women. A high index of suspicion is essential for early diagnosis. Laparoscopy may be indicated for diagnosis and for lysis of adhesions.
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PMID:Fitz-Hugh-Curtis syndrome. 367 61

We studied 23 patients with pelvic inflammatory disease associated with symptoms of pleuritic up'per abdominal pain, characteristic of Fitz-Hugh-Curtis syndrome (FHC). A fourfold or greater change in antibody titer to Chlamydia trachomatis was demonstrated by microimmunofluorescence in 14; an IgG antibody titer greater than or equal to 1:1,024 was seen in 13; and IgM antibody was demonstrated in 11. Twenty (87%) of the 23 FHC patients, including all of the 12 with paired sera obtained at least 6 weeks apart, had serologic evidence of acute C. trachomatis infection. Neisseria gonorrhoeae was isolated from seven (30%) of the 23 FHC cases, and C. trachomatis was isolated from three of 10. Two groups of matched controls were studied; one group with PID but without FHC, and the other without PID. A larger proportion of patients with FHC had serologic evidence of acute C. trachomatis infection than either of the two control groups (p less than 0.05 for each comparison). Among those with antibody to C. trachomatis, the geometric mean antibody titer for the FHC group (1:724) was significantly higher than that for the PID group (1:138) or for the non-PID group (1:103). Thus, FHC is not solely attributable to infection with N. gonorrhoeae; most cases are associated with acute C. trachomatis infection.
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PMID:Chlamydia trachomatis infection in Fitz-Hugh-Curtis syndrome. 678 46

Two cases of chlamydial pelvic inflammatory disease (PID) are presented. Each was clinically assessed and followed by laboratory methods now available to practitioners. These patients presented with vaginal discharge and chronic abdominal pain. They initially had positive chlamydia cultures which became negative after treatment with tetracycline. Their chlamydia titers increased throughout the course of their disease and treatment. Patient two is a case of the Fitz-Hugh-Curtis syndrome due to chlamydia. The importance of this disease in adolescents and the potential sequelae and complications of chlamydial PID are discussed.
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PMID:Chlamydial pelvic inflammatory disease in adolescents. 732 86

Two women aged 53 and 22 years presented with abdominal pain and signs of sepsis with metabolic acidosis. The first patient had ecchymoses all over her body, the second patient had an enlarged left kidney with wedge-shaped hypo-intense areas on the CT scan. The clinical condition of both women deteriorated. On laparoscopy perihepatitis with fibrin wires ('violin strings') was seen, pathognomonic for Fitz-Hugh-Curtis syndrome. Upon appropriate antibiotic treatment, both patients fully recovered. Although it is common belief that Fitz-Hugh-Curtis syndrome is caused by local spread from the fallopian tubes into the peritoneal cavity, these presentations suggest a haematogenous spread of Neisseria gonorrhoeae as well as Chlamydia trachomatis in the first case, and C. trachomatis in the second case.
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PMID:[Fitz-Hugh-Curtis syndrome: 2 patients with perihepatitis and sepsis]. 1205 Oct 66

We present CT findings of a 22-year-old woman diagnosed as Fitz-Hugh-Curtis syndrome. The patient was admitted to our hospital with right upper abdominal pain. Abdominal enhanced CT showed hepatic capsular enhancement over the medial segment and the right lobe on the early phase. This capsular enhancement completely disappeared after treatment. Abdominal enhanced CT may serve as a non-invasive modality for the diagnosis of Fitz-Hugh-Curtis syndrome.
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PMID:[A case of Fitz-Hugh-Curtis Syndrome representing hepatic capsular enhancement]. 1278 9

Fitz-Hugh-Curtis syndrome (FHCS) is a condition with right upper quadrant pain in association with pelvic inflammatory disease. Invasive procedures such as laparoscopy or laparotomy were indispensable to definite diagnosis of FHCS, and no more useful methods in radiological diagnosis of FHCS has been reported until now. In this present study abdominal enhanced-CT findings were analysed retrospectively in eight cases diagnosed clinically as FHCS. We focused on hepatic capsular enhancement, which was identified on early phase in all cases and on delayed phase in five. Moreover, hepatic capsular enhancement was detected at the anterior surface of medial segment and the lateral aspect of right lobe in all cases, while at the anterior surface of lateral segment in five cases. These findings, which disappeared on follow-up CT after treatment, were thought to reflect "acute" peri-hepatitis. Abdominal enhanced CT, especially on early phase, is suggested to be a non-invasive, useful modality for the diagnosis of FHCS. When hepatic capsular enhancement is identified in the interpretation of abdominal enhanced CT images in sexually active women who have right upper abdominal pain, we should suspect the possibility of FHCS and examine gynecological findings or the value of IgA and IgG antibodies for Chlamydia trachomatis.
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PMID:[Fitz-Hugh-Curtis syndrome: analysis of CT findings]. 1293 47

Chilaiditi syndrome is a condition in which the colon or small intestine is interposed temporarily or permanently between the liver and the diaphragm. Usually, it is an asymptomatic and incidental radiographic finding, but it may be a potential source of abdominal problems, ranging from intermittent mild abdominal pain to acute intestinal obstruction. We report multidetector computed tomographic findings of a case of Chilaiditi syndrome presenting as small bowel obstruction due to hepatodiaphragmatic interposition of the ileal loop, which was entrapped by adhesive bands caused by Fitz-Hugh-Curtis syndrome.
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PMID:Chilaiditi syndrome caused by Fitz-Hugh-Curtis syndrome: multidetector CT findings. 1613 30


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