Fitz-Hugh-Curtis 증후군과 단순 골반염의 임상양상 비교 분석
COMPARISON BETWEEN FITZ-HUGH-CURTIS SYNDROME AND UNCOMPLICATED PELVIC INFLAMMATORY DISEASE
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초록
목적Fitz-Hugh-Curtis 증후군(FHCS)은 골반염과 연관되어 발생하는 간 주변의 염증으로, 본 연구를 통해 FHCS의 임상양상, 진단 방법 등을 단순 골반염과 비교하여 알아보고자 하였다. 연구방법2007년 1월부터 2011년 8월까지 본원에서 골반염 및 FHCS으로 치료받은 93명의 여성을 대상으로 하여 다음과 같이 분류하였다. FHCS 환자군 41명, 단순 골반염 환자군 52명, 두 군의 주호소, 이학적 검사소견, 혈액검사 및 미생물학 검사 소견 등을 비교, 분석하였다. 결과분석결과 본원에서의 발병률은 전체 골반염 환자 중 14.3%로 측정되었다. 두 군 모두 대부분의 환자가 복통을 주소로 내원하였으나FHCS 환자군은 주로 우상복부통증(78.0%), 단순 골반염 환자군은 골반통(75%)을 호소하였다. 이학적 검사 소견을 분석한 결과 FHCS 환자군에서 단순 골반염 환자군에 비해 골반 장기 압통, 자궁경부 운동성 압통이 현저히 낮은 비율로 나타났다. C-반응성 단백질의 수치는FHCS 환자군에서 유의하게 높게 측정되었으며(P = 0.0175), Chlamydia trachomatis 의 양성률 또한 FHCS 환자군에서 92.7%로 단순 골반염 환자군에 비해 높았다. 결론FHCS에서는 전형적인 골반염의 증거가 결여된 경우가 있으므로 우상복부 통증을 주소로 내원한 여성에서는 반드시 부인과적 접근을 고려해야 할 것이다.
Abstract
Objective To compare the clinical characteristics, hematologic findings, microbiologic results of Fitz-Hugh-Curtis syndrome (FHCS) to uncomplicated pelvic infl ammatory disease (PID). Methods We retrospectively reviewed the medical records of 41 patients of FHCS and 52 patients of uncomplicated PID in Myongji Hospital from January 2007 to August 2011. Between the two groups, we compared clinical manifestations, physical examination fi ndings,hematologic fi ndings, microbiologic study fi ndings, abdomen and pelvic computed tomography. Results FHCS accounted for 14.3% of total cases of pelvic infl ammatory disease at our medical institution. Patients of both groups visited with a chief complaint of abdominal pain. The most common symptom was the right upper quadrant (RUQ) pain (78.0%) in the FHCS group and the pelvic pain (75%) in the uncomplicated PID group. The incidence of pelvic organ tenderness and cervical motion tenderness was lower in the FHCS group as compared with the uncomplicated PID group. FHCS group was associated with signifi cantly higher C-reactive protein level in comparison to that of uncomplicated PID group (P = 0.0175). In addition, higher incidence of chlamydial infection was noted in FHCS group. Conclusion The typical signs of PID were not evident in some cases of FHCS. A gynecologic approach would therefore be mandatory for further evaluation and treatment in women who visited with a chief complaint of the acute RUQ pain.
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