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Infectious Diseases in Obstetrics and Gynecology
Volume 2, Issue 6, Pages 263-266
Clinical Study

Perihepatic Adhesions: Another Look

Department of Obstetrics and Gynecology, 7 OPD, Temple University Hospital, 3401 N. Broad Street, Philadelphia 19140, PA, USA

Received 26 September 1994; Accepted 20 February 1995

Copyright © 1995 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective: The objective of our study was to determine if pelvic inflammatory disease (PID) was the only cause of perihepatic adhesions.

Methods: One hundred consecutive patients undergoing elective sterilization by laparoscopy were enrolled in this study. The preoperative workup included a history, physical examination, cervical culture for Neisseria gonorrhoeae and Chlamydia trachomatis, leukocyte count, C-reactive protein, and liver-function tests. During the laparoscopic procedure, the pelvis and liver surface were inspected for evidence of any adhesions. If perihepatic adhesions were discovered in a patient without any evidence of prior PID, then cultures from the adhesion, peritoneal fluid, and tubal specimens were obtained for N. 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 evidence of prior PID. The preoperative cultures were negative. Three of these patients had no history of sexually transmitted disease or PID. Their anti-chlamydial antibody titers were also negative. Of the remaining 4 patients with perihepatic adhesions, 2 had a history of gonococcal or chlamydial infection and 2 had histological evidence of chronic salpingitis.

Conclusions: The study suggests that PID may not be the only cause of perihepatic adhesions.