Prevalence of incidental perihepatic adhesions at laparotomy in cases of ovarian cancer

摘要

Fitz-Hugh-Curtis syndrome (FHCS)-which is observed in association with gonococcal or chlamydial salpingitis-involves the presence of perihepatitis [1]. In the acute phase, there is perihepatitis and focal peritonitis due to transport of inflammatory fluid to the subphrenic and subdiaphragmatic spaces. In the chronic phase, violin-string adhesions are formed between the anterior surface of the liver and the anterior abdominal wall. Fitz-Hugh-Curtis syndrome is classified as mild (<5 adhesions on the right lobe of the liver), moderate (>=5 adhesions on the right lobe of the liver), or severe (>5 adhesions on both lobes of the liver) [2]. Between January 1,2009, and December 31,2012, we looked for the presence of perihepatic adhesions in all cases of exploratory laparotomy for ovarian cancer at the All India Institute of Medical Sciences, New Delhi, India. To avoid observer bias, one of the authors (S.K., J.B.S.) was surgeon in all cases. Because the study involved retrospective collection of data, ethics clearance was not required, per hospital policy. Informed consent was received from all women for surgery.Data were collected for 182 women in whom the liver and surrounding areas were examined for adhesions. The adhesions were biopsied and subjected to histopathologic examination. No cases showed malignancy.