Fitz-Hugh-Curtis syndrome after laparoscopic tubal ligation. A case report.
BACKGROUND
Minimally invasive techniques are being used throughout all fields of surgery. With the increasing use and complexity of these cases, new complications will also develop. Fitz-Hugh-Curtis syndrome is an uncommon finding from the spread of infection in pelvic inflammatory disease, causing perihepatitis.


METHODS
A 29-year-old woman presented 2 weeks after an apparently uneventful laparoscopic tubal ligation with a complaint of right upper quadrant pain. She also had elevated liver function tests but normal ultrasound of the gallbladder. Eventually an intravenous pyelogram showed a bladder injury. Computed tomography revealed fluid in the pelvis and enhancement around the liver. During surgery, intense inflammation with multiple adhesions throughout the peritoneal cavity and around the liver were found.


CONCLUSIONS
The findings were similar to the perihepatitis that occurs when Fitz-Hugh-Curtis syndrome complicates pelvic inflammatory disease. The unusual presentation in this patient made diagnosis very difficult and should remind physicians that unusual complications must be considered as technology evolves and spreads throughout all surgical fields.
Department of Obstetrics and Gynecology, New York Methodist Hospital, East Pavilion, 4th floor, 506 6th Street, Brooklyn, NY 11215, USA. gsonal@hotmail.com
Sonal G
SG
Gandhi
Ian K
IK
Komenaka
Joseph H
JH
Naim
D000328:Adult; D003558:Cystoscopy / Q000379:methods; D003937:Diagnosis, Differential; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis*; D000292:Pelvic Inflammatory Disease / Q000150:complications / Q000175:diagnosis*; D018570:Risk Assessment; D013246:Sterilization, Tubal / Q000009:adverse effects* / Q000379:methods; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000293:injuries* / Q000601:surgery*