Fitz-Hugh-Curtis syndrome: Analysis of CT findings

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" perihepatitis. 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.