2004 Volume 46 Issue 7 Pages 1368-1372
A 20-years-old female was admitted to our hospital with a history of fever for four weeks. She also complained of upper abdominal pain. Laboratory tests suggested the existence of severe inflamation. Abdominal ultrasonography revealed only a hyper echoic shadow between the liver and the abdominal wall. The patient was diagnosed to have Fitz-Hugh-Curtis syndrome due to the presence of Anti-Chlamydia trachomatis anti-body, a hyperechoic shadow between the liver and the abdominal wall by abdominal ultrasonography and abdominal pain. Even, after conservative therapy, her abdominal pain was not disappeared, so we decided to perform laparoscopy for assessing both the existence and the severity of the adhesion. Laparoscopic examination revealed the existence of, so called, "violin string adhesions" between the anterior wall of the liver capsule and the abdominal wall, and Chlamydia tra-chomatis antigen in ascitic fluid was positive. The clearance of adhesion let to relieve her abdominal pain. In conclusion, a diagnosis of Fitz-Hugh-Curtis syndrome should be considered in f emele patients presenting with upper abdominal pain without any apparent causes. Laparoscopy appears to be beneficial not only for the diagnosis but also therapy in patients with Fitz -Hugh-Curtis syndrome.
