Abstract
Objective: The objective of our study was to determine if pelvic inflammatory disease (PID) was the only cause of perihepatic adhesions.
Methods: One hundred consecutive patients undergoing elective sterilization by laparoscopy were enrolled in this study. The preoperative workup included a history, physical examination, cervical culture for Neisseria gonorrhoeae and Chlamydia trachomatis, leukocyte count, C-reactive protein, and liver-function tests. During the laparoscopic procedure, the pelvis and liver surface were inspected for evidence of any adhesions. If perihepatic adhesions were discovered in a patient without any evidence of prior PID, then cultures from the adhesion, peritoneal fluid, and tubal specimens were obtained for N. gonorrhoeae, C. trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, anaerobes, and facultative aerobes. Tubal specimens were also obtained for histologic examination.
Results: Of 100 patients, 7 patients had perihepatic adhesions without any laparoscopic evidence of prior PID. The preoperative cultures were negative. Three of these patients had no history of sexually transmitted disease or PID. Their anti-chlamydial antibody titers were also negative. Of the remaining 4 patients with perihepatic adhesions, 2 had a history of gonococcal or chlamydial infection and 2 had histological evidence of chronic salpingitis.
Conclusions: The study suggests that PID may not be the only cause of perihepatic adhesions.
Full Text
The Full Text of this article is available as a PDF (320.4 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Amin-Hanjani S., Neely T., Chatwani A. Perihepatic adhesions: not necessarily pathognomonic of pelvic infection. Am J Obstet Gynecol. 1992 Jul;167(1):115–116. doi: 10.1016/s0002-9378(11)91640-8. [DOI] [PubMed] [Google Scholar]
- Kimball M. W., Knee S. Gonococcal perihepatitis in a male. The Fitz-Hugh--Curtis syndrome. N Engl J Med. 1970 May 7;282(19):1082–1084. doi: 10.1056/NEJM197005072821908. [DOI] [PubMed] [Google Scholar]
- Litt I. F., Cohen M. I. Perihepatitis associated with salpingitis in adolescents. JAMA. 1978 Sep 15;240(12):1253–1254. [PubMed] [Google Scholar]
- Owens S., Yeko T. R., Bloy R., Maroulis G. B. Laparoscopic treatment of painful perihepatic adhesions in Fitz-Hugh-Curtis syndrome. Obstet Gynecol. 1991 Sep;78(3 Pt 2):542–543. [PubMed] [Google Scholar]
- Reichert J. A., Valle R. F. Fitz-Hugh-Curtis syndrome. A laparoscopic approach. JAMA. 1976 Jul 19;236(3):266–268. [PubMed] [Google Scholar]