日本性感染症学会誌 Journal of Japanese Society for Sexually Transmitted Infections

Fitz-Hugh-Curtis syndrome (FHCS) is a form of acute peritonitis involving the abdomen and pelvis, caused by bacterial infections such as Chlamydia trachomatis. It is characterized by perihepatic inflammation. Patients with FHCS often present to general outpatient clinics or emergency departments with a chief complaint of right upper quadrant pain. Early diagnosis and prompt treatment with antimicrobial agents are essential to prevent complications such as infertility. Here, we report two cases of FHCS to reassess the diagnostic utility of enhanced abdominal computed tomography (CT). The patients were two women, aged 19 and 21 years, who presented to the emergency department with upper abdominal pain followed by nonspecific symptoms. In both cases, FHCS was diagnosed based on early enhancement of the liver capsule in the arterial phase of enhanced abdominal CT. C. trachomatis infection was subsequently confirmed by PCR testing of cervical canal specimens. Both patients were treated with azithromycin, resulting in resolution of symptoms within a few days. These cases highlight the importance of considering FHCS in the differential diagnosis of young women presenting with upper abdominal pain and of utilizing enhanced abdominal CT or MRI as part of the diagnostic workup when clinically indicated.