Fitz-Hugh-Curtis Syndrome and Associated Inflammatory Conditions

Fitz-Hugh-Curtis syndrome is characterised by inflammation of the hepatic capsule and formation of peritoneal adhesions in the context of ascending genital tract infection. Most commonly linked to Chlamydia trachomatis or Neisseria gonorrhoeae, it presents as acute or subacute right upper quadrant pain, often accompanied by pelvic discomfort, fever and elevated inflammatory markers. The hallmark finding at laparoscopy – “violin-string” adhesions between the liver capsule and the anterior abdominal wall – reflects perihepatitis rather than primary hepatic parenchymal disease. Beyond typical bacterial aetiologies, recent case series have highlighted associations with tuberculous salpingitis, nontuberculous mycobacterial infection and rare presentations in male patients. Diagnostic pathways now integrate careful clinical examination, targeted imaging and, where necessary, laparoscopic assessment. Early recognition and appropriate antimicrobial therapy limit chronic pain, prevent infertility and reduce the need for invasive adhesiolysis. Globally, the syndrome underscores the broader impact of pelvic inflammatory disease, particularly in regions with high rates of sexually transmitted infections and variable access to diagnostic resources.

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Fitz-Hugh-Curtis Syndrome and Associated Inflammatory Conditions publication trend

The graph below shows the total number of articles in fitz-hugh-curtis syndrome and associated inflammatory conditions across all publications each year (not limited to Nature Index journals).

Technical terms

Fitz-Hugh-Curtis syndrome: Inflammation of the liver capsule and adjacent peritoneum secondary to pelvic infection.

Perihepatitis: Inflammatory involvement of the hepatic capsule without primary liver parenchymal injury.

Pelvic inflammatory disease (PID): Infection of female upper genital tract structures, often ascending from the cervix.

Salpingitis: Inflammation of the fallopian tubes, frequently the origin point for ascending infection.

Violin-string adhesions: Fibrous strands seen at laparoscopy linking the liver capsule to the peritoneal surface.

References

1. Fitz-Hugh-Curtis syndrome associated with tuberculous salpingitis and peritonitis: a case presentation and review of literature. BMC Gastroenterology (2018).
2. Two Cases of Perihepatitis With the Liver Capsule Irritation Sign: A New Physical Examination Technique. Cureus (2023).
3. Fitz-Hugh-Curtis Syndrome in a Male Patient. Cureus (2024).
4. Nontuberculous mycobacterial infection in a clinical presentation of Fitz-Hugh-Curtis syndrome: a case report with multigene diagnostic approach. BMC Women's Health (2014).