CASE 351:ACUTE ABDOMEN POST PARTUM , Dr PHAN THANH Dr VO NGUYEN THANH NHAN, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

Woman 24 yo post partum,  pain at  right pelvis and fever. But one day after, pain  at  liver region, palpation  is very painful at Murphy  area liked  cholecystitis.Ultrasound of abdomen cannot detect   cause of pain, no stone in gallbladder , no thickening of the wall of gallbladder, no free air or free fluid at Morrison space (see US pictures 1, 2)

Ultrasound at pelvis  revealed thickening  of pelvic  peritoneum and hypervacular  at right tubal uterus ( US 3).

MSCT of  abdomen without  CE cannot detect abnormal ( CT 1);   with CE  injection, in delay  phase  radiologist  reported   abnormal perihepatic contrast enhanced.

Blood tests :  high CRP of 104.89ng/ml, WBC  normal.Suggestion for this case is perihepatitis and PID [pelvic inflammatory disease] FIZT-HUGH-CURTIS SYNDROME.