Fitz-Hugh-Curtis syndrome is a condition in which strands of fibrous scar tissue form between the liver and the abdominal wall, as a result of liver capsule inflammation. This liver tissue inflammation is typically caused by an infection spreading from the female reproductive system. Such infections tend to spread upward from the vagina to affect the womb and fallopian tubes, and are referred to as pelvic inflammatory disease. A woman with Fitz-Hugh-Curtis syndrome typically experiences sharp pains high up on the right side of the abdomen, sometimes with signs of infection such as fever and nausea. Antibiotics are generally used to treat the condition.
Up to around 14 percent of women with pelvic inflammatory disease, or PID, are thought to develop Fitz-Hugh-Curtis syndrome. The condition is thought to be more common in teenagers, and occasionally occurs in men, in which case it is not associated with PID. There are two main types of bacteria known to cause this syndrome. These are Neisseria gonorrhoeae and Chlamydia trachomatis, with Chlamydia trachomatis being more commonly found. It is not yet fully understood how infection spreads from the pelvis to affect the liver.
The effect of Fitz-Hugh-Curtis syndrome on the liver causes tissue strands, known as adhesions, to form between the capsule that contains the liver and the lining of the abdominal wall. Adhesions are found in other parts of the body and arise as part of the body's response to events such as injuries, infections or surgery. As adhesions normally tie things together abnormally, they can cause pain when movement leads to pulling and stretching. In Fitz-Hugh-Curtis syndrome the liver adhesions are described as resembling violin strings, and sharp pains may be experienced with certain movements or with coughs and sneezes which affect the pressure in the abdomen. The condition can be difficult to distinguish from gallbladder disease as the symptoms can be similar.
Diagnosing Fitz-Hugh-Curtis syndrome involves using a cotton swab to take a sample of bacteria from the neck of the womb to determine whether a woman has a chlamydial or a gonococcal perihepatitis. It is important to exclude other diseases which may have similar symptoms, such as gallbladder and kidney problems. Fitz-Hugh-Curtis syndrome is treated using antibiotics which are targeted specifically at the bacteria causing the infection. Sexual partners should also be treated for infection if possible. Sometimes pain relieving drugs may be required and, occasionally, the adhesions may need to be cut surgically.