Fitz-Hugh-Curtis syndrome resulting in nutmeg liver on computed tomography

Jolien P de Boer; Inez M Verpalen; Ruben Y Gabriëls; Harm de Haan; Maarten Meijssen; Peter Bloembergen; Mark Meier

doi:10.1016/j.radcr.2019.04.008

Fitz-Hugh-Curtis syndrome resulting in nutmeg liver on computed tomography

Radiol Case Rep. 2019 May 24;14(8):930-933. doi: 10.1016/j.radcr.2019.04.008. eCollection 2019 Aug.

Authors

Jolien P de Boer¹, Inez M Verpalen², Ruben Y Gabriëls³, Harm de Haan¹, Maarten Meijssen³, Peter Bloembergen⁴, Mark Meier²

Affiliations

¹ Department of Gynaecology, Isala hospital, Dokter van Heesweg 2, Zwolle 8025 AB, the Netherlands.
² Department of Radiology, Isala hospital, Zwolle, the Netherlands.
³ Department of Gastroenterology, Isala hospital, Zwolle, the Netherlands.
⁴ Laboratory of Medical Microbiology and Infectious Diseases, Isala hospital, Zwolle, the Netherlands.

Abstract

A 34-year-old woman entered the emergency room with abdominal pain in the right upper quadrant. Computed tomography scan showed a nutmeg liver suspected for increased venous pressure by thrombosis of the liver veins, Budd-Chiari malformation, or right-sided heart failure. Interestingly, the diagnosis was pelvic inflammatory disease complicated by the Fitz-Hugh-Curtis syndrome (FHCS). Pelvic inflammatory disease resulted from an ascended infection by Chlamydia trachomatis. FHCS was caused by perihepatitis defined as inflammation of the peritoneal capsule of the liver. Fast diagnosis and treatment is crucial. Therefore, we report a case of FHCS characterized by a nutmeg liver on computed tomography.

Keywords: Chlamydia trachomatis; FHCS, Fitz-Hugh-Curtis syndrome; Fitz-Hugh-Curtis syndrome; GP, general practitioner; Hepatomegaly; IUD, intrauterine device; Nutmeg liver; PID, pelvic inflammatory disease; Pelvic Inflammatory disease; Perihepatitis.

Publication types

Case Reports