Perihepatic Adhesions: Another Look

[摘要] Objective:The objective of our study was to determine if pelvic inflammatory disease (PID) was theonly cause of perihepatic adhesions.Methods:One hundred consecutive patients undergoing elective sterilization by laparoscopy wereenrolled in this study. The preoperative workup included a history, physical examination, cervicalculture forNeisseria gonorrhoeaeandChlamydia trachomatis, leukocyte count, C-reactive protein,and liver-function tests. During the laparoscopic procedure, the pelvis and liver surface were inspectedfor evidence of any adhesions. If perihepatic adhesions were discovered in a patient withoutany evidence of prior PID, then cultures from the adhesion, peritoneal fluid, and tubal specimenswere obtained forN. gonorrhoeae, C. trachomatis, Mycoplasma hominis, Ureaplasma urealyticum,anaerobes, and facultative aerobes. Tubal specimens were also obtained for histologic examination.Results:Of 100 patients, 7 patients had perihepatic adhesions without any laparoscopic evidenceof prior PID. The preoperative cultures were negative. Three of these patients had no history ofsexually transmitted disease or PID. Their anti-chlamydial antibody titers were also negative. Of theremaining 4 patients with perihepatic adhesions, 2 had a history of gonococcal or chlamydialinfection and 2 had histological evidence of chronic salpingitis.Conclusions:The study suggests that PID may not be the only cause of perihepatic adhesions.

[学科分类] 妇产科学