Journal List > Korean J Obstet Gynecol > v.54(1) > 1088312

Shin, Kim, Chang, Jun, Jeon, and Kim: Clinical features of Fitz-Hugh-Curtis syndrome diagnosed by abdomino-pelvic computed tomography



To analyze the clinical characteristics in patients of Fitz-Hugh-Curtis syndrome diagnosed by abdomino-pelvic computed tomography (CT).


We retrospectively examined the clinical courses of 62 patients who visited with abdominal pain from March 2005 to July 2010. The clinical manifestations, physical examination, laboratory manifestations, CT findings, treatments, and prognosis were analyzed.


The mean age of the patients ranged from 13 to 48 years and their average age was 28.56±8.77. Twenty-eight of them (45.2%) were married but all the subjects had sexual experience. The chief complaints requiring a visit to the hospital were abdominal pain (74.2%), vaginal discharge (19.4%), nausea and vomiting (3.2%), and fever (1.6%). On physical examination, location of tenderness was right upper-quadrant tenderness (41.9%), whole abdomen (37.1%), right lower-quadrant (24.2%), lower abdomen (16.1%), and epigastric area (6.5%). The isolation of bacterial pathogens was found in 26% (13/62) of them. Polymerase chain reaction tests for Chlamydia trachomatis were positive in 34 patients (70.3%). All 62 cases showed liver capsular enhancement on CT in the early arterial phase. Peritoneal thickening (24.2%) and fluid collection (27.4%) were observed in the perihepatic area. Of 56 patients, 49 patients (87.5%) improved following antibiotic therapy and conservative care. Seven patients did not respond to antibiotic therapy, their symptoms improved after laparoscopic surgery.


For women of reproductive age with acute pain in the upper right abdominal alone or together with pain in the lower abdomen, Fitz-Hugh-Curtis syndrome should be suggested during examination. Moreover, in cases suspected to be Fitz-Hugh-Curtis syndrome, gynecologic examination, abdomino-pelvic CT, and tests for C. trachomatis could provide a more rapid and accurate diagnosis. Also, education and continuous follow up after therapy would be needed.

Figures and Tables

Table 1
Clinical manifestations of 62 patients with Fitz-Hugh-Curtis syndrome

Values are presented as mean±standard deviation or number (%).

RUQ, right upper quadrant; RLO, right lower quadrant; LLQ, left lower quadrant.

Table 2
Laboratory findings and computed tomography findings in patients with Fitz-Hugh-Curtis syndrome

Values are presented as mean±standard deviation (SD) or number (%).

WBC, white blood cell; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; AST, aspartate aminotransferase; ALT, alanine aminotransferase; PCR, polymerase chain reaction; PID, pelvic inflammatory disease; TOA, tubo-ovarian abscess.


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