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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four of our patients had classical Fitz-Hugh-Curtis syndrome. Persistent right upper-gradrant pain prompted extensive medical evaluation; anibiotic therapy fialed to relieve the symptoms. In each case, laparoscopy proved to be an ideal method for obtaining definitive diagnosis and therapy. Typical perihepatic violin-string adhesions were cauterized and divided under direct vision with dramatic resolution of symptoms.
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PMID:Fitz-Hugh-Curtis syndrome. A laparoscopic approach. 13 40

A 25-year-old Japanese female was admitted to the Department of Surgery in Kyushu Koseinenkin Hospital because of serious right hypochondralgia. Gastrofiberscopy, abdominal ultrasonography, intravenous pyelography and irrigoscopy did not reveal the origin of the pain, and she was introduced to the Department of Internal Medicine. Because enzyme immunoassay of the uterine cervical specimen in the Department of Urology showed positive chlamydial antigen, we suspected her of perihepatitis induced by Chlamydia trachomatis (Fitz-Hugh-Curtis syndrome). Laparoscopy revealed typical violin string adhesions between the anterior surface of the liver and the corresponding parietal peritoneum, and the diagnosis was confirmed. After an administration of Ofloxacin was started, the symptom disappeared completely. It is considered to be important to remember this syndrome when examining a young women with right hypochondralgia.
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PMID:[A case of Fitz-Hugh-Curtis syndrome confirmed by laparoscopy]. 153 31

The authors describe the development of the disease in a 15-year-old girl hospitalized on account of temperatures and vague pain in the right hypogastrium. Within a short time the pain shifted to the right epigastrium, became more intensive (with deterioration during inspiration) and concurrently the patient developed marked muscular tension in the whole right upper abdominal quadrant. The condition was associated with leucocytosis and a high red cell sedimentation rate. Marked tenderness and muscular tension persisted for cca 48 hours, afterwards, following symptomatic treatment, relatively rapid regression of the complaints and clinical picture occurred. Auxiliary examinations did not reveal any marked pathological changes of the abdominal and thoracic organs. Only during the post-acute phase of the disease gonococcal infection of the sex organs was revealed and adequate treatment was started. The authors evaluated the disease as gonococcal perihepatitis, known in the literature as Fitz-Hugh-Curtis syndrome.
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PMID:[The Fitz-Hugh-Curtis syndrome in a 15-year-old girl]. 178 4

This report illustrates a case of Fitz-Hugh-Curtis syndrome associated with pelvic inflammatory disease in which the clinical symptom of right upper quadrant pain was severe and persistent despite appropriate antibiotic therapy. Because of the atypical course, an extensive work-up was performed to rule out other possible etiologies for the pain. In this context, a laparoscopy was performed and identified dense adhesions between the liver and the anterior abdominal wall. These adhesions were safely and successfully lysed using a KTP/532 laser through a second puncture site. After surgery the pain was completely resolved, with no further recurrence after 6 months of follow-up.
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PMID:Laparoscopic treatment of painful perihepatic adhesions in Fitz-Hugh-Curtis syndrome. 183 Dec 53

The Fitz-Hugh-Curtis syndrome (FHCS), or perihepatitis as a complication of pelvic inflammatory disease (PID), is readily diagnosed by laparoscopy. Among 274 non-selected cases of acute PID verified laparoscopically, FHCS was found in 38 (13.8 per cent). Twenty-four of the patients presented right-upper-quadrant pain and tenderness, while 14 experienced no local symptoms. Perihepatitis was found in a slightly higher frequency in PID cases of low age and in those using intrauterine contraception (IUCD) but the differences lack statistical significance. However, acute PID occurring within 6 weeks after IUCD insertion was associated significantly more often with FHCS (p less than 0.01). It is suggested that the traumatizing effect of IUCD insertion facilitates the spread of pelvic inflammatory material to the perihepatic region.
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PMID:Perihepatitis in pelvic inflammatory disease--association with intrauterine contraception. 738 90

Recently, Chlamydia trachomatis infection in sexually active women has increased. C. trachomatis cause pelvic inflammation. A few of these patients develop Fitz-Hugh-Curtis syndrome (FHCS). Clinical symptoms of FHCS include pain of sudden onset in the right upper quadrant mimicking acute biliary disease. Diagnosis of FHCS has been weighed upon laparoscopic findings. Since FHCS is a benign disorder which responds to appropriate antibiotics, non-invasive diagnostic method would be expected. We report here two cases of FHCS, diagnosed by a high serum antibody titer against C. trachomatis and clinical manifestations. Both cases showed small effusion in the pelvic cavity detected by ultrasonography, one of them was associated with small effusion in the right perirenal space suggesting perinephritis. Detection of small effusion intra abdominal cavity or pelvic space could be useful for non-invasive diagnosis of FHCS.
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PMID:[Useful abdominal ultrasonography for diagnosis of Fitz-Hugh-Curtis syndrome: two case reports]. 774 11

A case of Fitz-Hugh-Curtis syndrome (venereal perihepatitis) is reported. This syndrome is observed almost exclusively in women as a complication of genital gonococcal or chlamydial infections. A sudden, acute biliary-type pain generally characterizes the disease; only a few cases present symptoms related to associated genital infection. The real clinical incidence of venereal perihepatitis is quite high; in fact, a lot of the emergency admitted patients diagnosed with biliary colic or acute cholecystitis as a matter of fact suffer from this syndrome. If haematological investigations, ultrasonography and cholangiography do not confirm a suspected biliary lithiasis, it will be needed to investigate the genital tract. After clinical and ultrasound examinations, neisseria gonorrhoeae and chlamydia trachomatis must be sought in vaginal and cervical secretions and serum antichlamydial antibodies level is to be sought too. Through these examinations, the venereal perihepatitis can usually be diagnosed. In uncertain cases laparoscopy can be useful: in fact, it can reveal the typical violin-string-like adhesions between the anterior liver capsule and the anterior abdominal wall, and, in the same session, it allow to resect them. Tetracycline, doxycycline and, more recently, ofloxacine gave good results in the syndrome's treatment.
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PMID:[Venereal perihepatitis: Fitz-Hugh-Curtis syndrome]. 858 15

The Fitz-Hugh-Curtis syndrome is a peri-hepatitis following a genital infection. It usually occurs in young women. Chlamydia trachomatis is the most frequent causal agent. Clinical signs include acute or recurrent pain in the right hypochondria. Liver tests are not modified and the sonographic examination is normal. Diagnosis can be suspected on the basis of serology, and formally established by laparoscopy showing violin string-like adhesions. Prolonged antibiotic treatment is effective.
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PMID:[Bacterial perihepatitis]. 1184 26

The Fitz-Hugh-Curtis syndrome was diagnosed intraoperatory at 7.1% of the laparoscopic cholecystectomies in our clinic. The attitude in all cases was to perform a complete adhesiolysis. The reasons we consider that support this are: 1. the adhesions that fix the liver to the diaphragma do not allow the surgeon a comfortable access to perform cholecystectomy; 2. if these adhesions are torn accidentally during operation it could end up to the glissonian sheath rupture and uncontrollable bleeding; 3. adhesiolysis might be imposed in order to introduce the ports under visual control; 4. the traction determined by the perihepatitis process against the parietal peritoneum could be responsible for postoperative right quadrant pain; 5. the hepatodiaphragma adhesions make impossible the suction of the intraoperative secretions. A complete adhesiolysis allow a correct lavage of the suprahepatic area preventing the possible retention of clots, bile or even calculi. We didn't notice neither a longer duration of the intervention due to adesiolysis nor intra/or postoperative complications.
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PMID:[The Fitz-Hugh-Curtis syndrome in laparoscopic surgery]. 1273 Dec 13

Fitz-Hugh-Curtis syndrome has been defined as perihepatitis accompanying pelvic inflammatory disease caused by Neisseria gonorrhoeae and Chlamydia trachomatis. In the acute phase, patients usually complain of severe right upper quadrant pain of sudden onset. The pain is sharp, pleuritic and most intense at the level of the right lower rib margin and thus it is frequently confused with acute cholecystitis or pleurisy. Definitive diagnosis of Fitz-Hugh-Curtis syndrome needs invasive procedures such as laparoscopy or laparotomy, but considering that Fitz-Hugh-Curtis syndrome is a benign condition that can be cured by oral administration of appropriate antibiotics, noninvasive diagnosis is desirable. Recently, we have experienced two cases of Fitz-Hugh-Curtis syndrome in acute phase accompanied with sharp and pleuritic right upper quadrant pain. In one case, pelvic inflammatory disease was not definite, so at first we mistook it for acute cholecystitis and reactivation of chronic hepatitis B. In the other case, Fitz-Hugh-Curtis syndrome followed the preceding, typical pelvic inflammatory disease. Both cases were diagnosed noninvasively and treated successfully by oral administration of antibiotics.
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PMID:[Two cases of Fitz-Hugh-Curtis syndrome in acute phase]. 1572 19


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