Fitz-Hugh-Curtis Syndrome—Pelvic Inflammatory Disease: A Predictor of Difficult Cholecystectomy

Abstract

Difficult laparoscopic cholecystectomy is a condition that every general surgeon has once faced during surgery. There have been various propositions regarding the aetiology and criteria for difficult cholecystectomy. As a whole, it has been associated with abnormal anatomy, frozen Calot’s triangle, difficult exposure, post endoscopic retrograde cholangio-pancreatography, requiring more than 90 min, need for open conversion, etc. There are various preoperative and intraoperative predictors of difficult cholecystectomy described in the literature. However, history of severe pelvic inflammatory disease preoperatively has not been described in the literature as a predictor of difficult cholecystectomy. In our case report, a 31-year-old lady presented to us with biliary colic. Ultrasonography revealed a normal wall gall bladder, with multiple calculi. Diagnosis of symptomatic cholelithiasis was made. Based on clinical history and intraoperative findings, a diagnosis of Fitz-Hugh-Curtis syndrome was made, which is a sequelae of pelvic inflammatory disease.