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Fitz-Hugh-Curtis Syndrome as Finding during Open Cholecystectomy and Unknown Pregnancy: Clinical Case
Guillermo Padrón Arredondo*Department of Surgery, General Hospital of Playa del Carmen, Solidaridad, Quintana Roo, Mexico
- Corresponding Author:
- Dr. Guillermo Padron Arredondo
Cda. Corales 138, Residential Playa del Sol Playa del Carmen
Solidaridad, Q. Roo. CP, 77710, México
Tel: 984-876-2267
E-mail: gpadronarredondo@hotmail.com
Received Date: August 02, 2016; Accepted Date: September 06, 2016; Published Date: September 12, 2016
Citation: Arredondo GP (2016) Fitz-Hugh-Curtis Syndrome as Finding during Open Cholecystectomy and Unknown Pregnancy: Clinical Case. J Gastrointest Dig Syst 6:468. doi:10.4172/2161-069X.1000468
Copyright: © 2016 Arredondo GP. This is an open-access article distributed under the terms of the Creative Commons Attribution License; which permits unrestricted use; distribution; and reproduction in any medium; provided the original author and source are credited.
Abstract
Introduction: The Fitz-Hugh-Curtis syndrome is a perihepatitis produced by secondary peritonitis the rise of bacteria, as a result of pelvic inflammatory disease. In the chronic stage can be observed adhesions between abdominal wall and the liver surface characterized by the similarity to "violin strings". This image is considered diagnostic criterion.
Clinical case: Female 37 years-old, Gesta 7, Births 5, Abortion 1, Cesarean Section 0, who intervenes surgically open to present intermittent pain for gallstone cholecystitis two years of evolution. Normal vital signs; Laboratory test preoperative: erythrocytes 3.40 × 106, hemoglobin 9.9 g/dl, hematocrit 33.8%, lymphocytes 19%, leukocytes 11.86 × 103/mm3, total neutrophil 86%. Glucose 139 mg/dl, BUN 4.35 mg/dl, urea 9.3 mg/dl, SGOT (AST) 80 U/I, SGPT (ALT) 66 U/I, Proteins 6.0 g/dl, serum albumin 3.4 mg/dl. VDRL Neg. Urinalysis: Urobilinogen 2 mg/dl; Leukocyte 15-20 x field and postoperatory pregnancy test (+). It proceeds to open cholecystectomy and during exposure of the gallbladder is located in hepatic parenchyma multiple adhesions and congestive liver.
Discussion: The combination of a painful liver without biochemical evidence of hepatitis or biliary obstruction, and menorrhagia raised the suspicion of perihepatitis Fitz-Hugh-Curtis, an inflammatory process of the liver capsule due to pelvic inflammatory disease mostly caused by Chlamydia trachomatis or Neisseria gonorrhoeae. The pathophysiology of perihepatitis FHC is unclear, but direct infection of the liver capsule, hematologic or lymphatic spread as well as an exaggerated immune response has been suggested.
