What’s Fitz-Hugh-Curtis Syndrome?

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Fitz-Hugh-Curtis syndrome is a condition in which strands of fibrous scar tissue form between the liver and the abdominal wall, due to inflammation of the liver capsule. This inflammation of the liver tissue is typically caused by an infection spreading from the female reproductive system. Such infections tend to spread upwards from the vagina to affect the uterus and fallopian tubes and are referred to as pelvic inflammatory disease. A woman with Fitz-Hugh-Curtis syndrome typically experiences sharp pains in the upper 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 about 14 percent of women with pelvic inflammatory disease, or PID, are thought to develop Fitz-Hugh-Curtis syndrome. The condition is thought to be most common in adolescents 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 most commonly found. It is still not fully understood how the infection spreads from the pelvis to affect the liver.

The effect of Fitz-Hugh-Curtis syndrome on the liver causes strands of tissue, known as adhesions, to form between the capsule that contains the liver and the lining of the abdominal wall. The adhesions are found in other parts of the body and arise as part of the body’s response to events such as injury, infection, or surgery. Because adhesions normally bind things together in an abnormal way, 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 felt with certain movements or with coughing and sneezing 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 cervix to determine whether a woman has chlamydia or gonococcal perihepatitis. It’s important to rule out other diseases that may have similar symptoms, such as gallbladder and kidney problems. Fitz-Hugh-Curtis syndrome is treated with antibiotics that specifically target the bacteria causing the infection. If possible, sexual partners should also be treated for the infection. Sometimes pain medications may be needed, and occasionally the adhesions may need to be surgically cut.

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