Imaging of Perisplenitis as an Unusual Presentation of the Fitz-hugh-curtis Syndrome

Abstract

Objective − We present the imaging characteristics of an unusual case of Fitz-Hugh-Curtis syndrome (FHCS), a late complication of pelvic inflammatory disease in an adolescent girl with left upper abdominal pain due to perisplenitis seen on contrast-enhanced ultrasound and magnetic resonance imaging.

Case Report − A 16-year-old girl presented with acute abdominal pain in the left upper quadrant, vomiting, diarrhoea, and vaginal odour with yellow discharge. She was recently diagnosed with infectious mononucleosis. Abdominal ultrasound showed perisplenic fluid collection that did not enhance post-contrast application, but it did show a mild enhancement of perisplenic tissue. MRI findings indicated perisplenitis. The results of the positive vaginal swab for Chlamydia trachomatis and Ureaplasma parvum and the imaging findings favoured a final diagnosis of FHCS with perisplenitis.

Conclusion − Imaging findings, and clinical and laboratory data, including positive vaginal swabs, are crucial to confirm the unusual presentation of FHCS in an adolescent with left upper abdominal pain.