Fitz Hugh Curtis Syndrome

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Classification according to ICD-10
K67 * Diseases of the peritoneum in infectious diseases classified elsewhere
ICD-10 online (WHO version 2019)
Perihepatic adhesions.jpg
Adhesions between liver surface and diaphragm after Fitz-Hugh-Curtis syndrome

The Fitz-Hugh-Curtis syndrome (also: Fitz-Hugh and Curtis syndrome , FHC syndrome ) is a rather rare complication of inflammation in the pelvis (PID, pelvic inflammatory disease ).


The symptoms consist of pain in the upper right quadrant of the abdomen , which may radiate into the right shoulder and intensify as the abdominal pressure increases (pressing, coughing , sneezing). Sometimes nausea and vomiting are added.

root cause

Fitz-Hugh-Curtis syndrome occurs predominantly after salpingitis due to a chlamydial infection or gonorrhea , which is why it almost exclusively affects women. About 15% to 30% of women with PID develop FHC syndrome. The underlying cause is usually an inflammation of the tissue surrounding the liver, a so-called perihepatitis.


Treatment is through adequate treatment of the underlying disease. As a complication of the FHC syndrome, local perihepatic purulent-fibrinous peritonitis (perihepatitis) can lead to adhesions between the liver and the abdominal wall or the diaphragm . These can be removed laparoscopically if this is necessary due to symptoms.


The clinical picture was first described as such in 1930 by the American gynecologist Arthur Hale Curtis (1881–1955). The American internist Thomas Fitz-Hugh Jr. (1894–1963) confirmed the observations in 1934. As early as 1920, the Uruguayan surgeon Carlos Stajano (1891–1976) reported changes to the diaphragm in gynecology .


  • C. Stajano: La reaction frenica en ginecologica. In: La semana médica, Buenos Aires. 1920; 27, pp. 243-248.
  • AH Curtis: A Cause of Adhesion in the Right Upper Quadrant. In: JAMA. 1930; 94, pp. 1221-122.
  • T. Fitz-Hugh Jr .: Acute gonococcic peritonitis of the right upper quadrant in women. In: JAMA. 1934; 102, pp. 2094-2096.
  • NG Peter, LR Clark, JR Jaeger: Fitz-Hugh-Curtis syndrome: a diagnosis to consider in women with right upper quadrant pain. In: Cleveland Clinic journal of medicine. 71 (2004), pp. 233-239, PMID 15055246 , doi: 10.3949 / ccjm.71.3.233

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