General and Abdominal Scientific and Case Reports Session 1
Chilaiditi Syndrome Caused by Fitz-Hugh-Curtis Syndrome: Ultrasound and CT Findings
Tuesday, April 9, 2024
12:22pm – 12:29pm
Location: 410
Authors: Andrew Nguyen, NYP Brooklyn Methodist Hospital Sarah Bella, New York Presbyterian Brooklyn Methodist Jaqueline Gomberg, NYU Langone/ Bellevue
Fitz-Hugh-Curtis syndrome is a rare complication of pelvic inflammatory disease (PID) mostly affecting women of childbearing age. Patients will typically present to the emergency room with acute right upper quadrant abdominal pain. While several cases have reported on Fitz-Hugh-Curtis syndrome causing a small bowel obstruction, our case presents an evaluation that was initially driven by sonographic findings. A 50-year-old patient presented for three days of intractable abdominal pain and the inability to pass flatus. Point-of-care ultrasound (POCUS) findings demonstrated dilated loops of small bowel. Contrast-enhanced CT imaging revealed incarcerated loops of small bowel in the hepatodiaphragmatic space diagnostic of Chilaiditi syndrome (CS). Laparoscopic evaluation showed adhesive bands consistent with Fitz-Hugh-Curtis syndrome. CS is defined by the interposition of bowel between the hepatic and diaphragmatic space, often an incidental finding on CT imaging. This case demonstrates a rare instance where CS was visualized via POCUS thereby promptly identifying a bowel obstruction secondary to Fitz-Hugh-Curtis syndrome. Providers will benefit in maintaining a high index of suspicion for Fitz-Hugh-Curtis syndrome and quickly recognizing the potential complications, including bowel obstruction.