Perihepatitis in Pelvic Inflammatory Disease — Association with Intrauterine Contraception

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Abstract
The Fitz-Hugh-Curtis syndrome (FHCS), or perihepatitis as a complication of pelvic inflammatory disease (PID), is readily diagnosed by laparoscopy. Among 274 non-selected cases of acute PID verified laparoscopically, FHCS was found in 38 (13.8 per cent). Twenty-four of the patients presented right-upper-quadrant pain and tenderness, while 14 experienced no local symptoms. Perihepatitis was found in a slightly higher frequency in PID cases of low age and in those using intrauterine contraception (IUCD) but the differences lack statistical significance. However, acute PID occurring within 6 weeks after IUCD insertion was associated significantly more often with FHCS (p < 0.01). It is suggested that the traumatizing effect of IUCD insertion facilitates the spread of pelvic inflammatory material to the perihepatic region.

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