Fitz-Hugh-Curtis syndrome

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Background

A complication of Pelvic Inflammatory Disease, involving acute gonococcal peritonitis of the right upper quadrant in women
Pain is caused by liver capsule inflammation

Clinical Features

Sudden onset severe right upper quadrant abdominal pain, distal pleuritic component +/- radiation to the shoulder ^[1]

Investigations

Aminotransferases usually normal or mildly elevated ^[1]

Differential Diagnosis

RUQ Pain

Gallbladder disease
- Symptomatic cholelithiasis (biliary colic)
- Choledocholithiasis
- Acute cholecystitis
- Ascending cholangitis
- Acalculous cholecystitis
Pancreatitis
Acute hepatitis
Pancreatitis
GERD
Appendicitis (retrocecal)
Pyogenic liver abscess
Bowel obstruction
Cirrhosis
Budd-Chiari syndrome
GU
Other
- Hepatomegaly due to CHF
- Peptic ulcer disease with or without perforation
- Pneumonia
- Herpes zoster
- Myocardial ischemia
- Pulmonary embolism
- Abdominal aortic aneurysm

Management

Sources

↑ ^1.0 ^1.1 Livengood et al. Clinical features and diagnosis of pelvic inflammatory disease. Uptodate.

Authors:

[multiple-1] 1.0 ^1.1 Livengood et al. Clinical features and diagnosis of pelvic inflammatory disease. Uptodate.

[1]