Case 338:   Fitz-Hugh-Curtis Syndrome

Diagnostic Category:

Clinical Presentation:

21 year old woman with prior history of Chlamydia and UTI presenting with leukocytosis and abdominal pain.

CT: Capsular enhancement

Imaging Findings:

Single phase CT scan shows decreased central parenchymal attenuation and increased subcapsular enhancement. Periportal and gallbladder wall edema (i.e. gallbladder fossa edema) is also present.  These findings represent perihepatitis secondary to inflammation of the Glisson's capsule, which is the characteristic finding of Fitz-Hugh-Curtis syndrome. 

Fitz-Hugh-Curtis syndrome consists of inflammatory extension from Chlamydia or gonococcal infection to the peritoneum, in particular the liver capsule.  Ascites with peritoneal septations can also occur, in additon to gallbladder wall edema.