A laparoscopy performed for suspected PID in a sexually active 25-year-old reveals violin-string adhesions between the liver capsule and anterior abdominal wall. This finding is:

• A Primary hepatic endometriosis
• B Adhesions from prior appendiceal perforation
• C Laparoscopic finding of Meigs syndrome
• D Fitz-Hugh–Curtis syndrome, caused by perihepatitis secondary to ascending genital tract infection ✓

Explanation

Fitz-Hugh–Curtis syndrome is perihepatitis arising as a complication of PID, most commonly due to Chlamydia trachomatis (also Neisseria gonorrhoeae). Chlamydial antigens reach the liver capsule via transperitoneal spread or hematogenous/lymphatic routes, causing adhesions between the liver capsule (Glisson's capsule) and anterior abdominal wall, classically described as 'violin-string' adhesions on laparoscopy. It manifests as right upper quadrant pain mimicking cholecystitis but in a young woman with PID. Treatment is the same as for PID.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.