A 24-year-old woman undergoes laparoscopy for infertility investigation. Violin-string adhesions are found between the liver capsule and the parietal peritoneum. This laparoscopic finding is most characteristic of:

• A Primary biliary cholangitis
• B Genital tuberculosis with peritoneal spread
• C Meigs syndrome
• D Fitz-Hugh-Curtis syndrome (perihepatitis complicating PID due to Chlamydia or Neisseria gonorrhoeae) ✓

Explanation

Fitz-Hugh-Curtis syndrome is perihepatitis complicating pelvic inflammatory disease, most commonly due to Chlamydia trachomatis and less commonly Neisseria gonorrhoeae. Violin-string adhesions between the liver surface and anterior abdominal wall are pathognomonic. The condition is often found incidentally at laparoscopy and should prompt investigation and treatment for PID. Genital TB may cause peritoneal adhesions but not this specific perihepatic pattern.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.