case_images: PMC9972719_01
case_images: The technique of examination of the liver capsule irritation sign.. First, an abdominal examination is performed in the supine position (A). Next, the patient is placed in the left lateral decubitus, and the abdomen is palpated (B). A positive result is obtained when there is increased tenderness and spontaneous pain in the right upper abdomen. This figure depicts the procedure for evaluation of the liver capsule irritation sign in a normal male participant (not any of the patients from this study), to showcase the method employed for the two patients described in this study.
case_images: cureus-0015-00000034327-i01.jpg
case_images: PMC9972719_02_cureus-0015-00000034327-i01.jpg
case_images: FIG1
case_images: When the patient was placed in the left lateral recumbent position and the abdomen was palpated (as per the procedure described in Figure 1), tenderness and spontaneous pain increased in the right upper abdomen (liver capsule irritation sign).
case_images: Early phase of contrast-enhanced CT of the abdomen.. A contrast effect was observed along the liver capsule, mainly in the right lobe of the liver. CT: computed tomography.
case_images: cureus-0015-00000034327-i02.jpg
case_images: PMC9972719_01_cureus-0015-00000034327-i02.jpg
case_images: FIG2
case_images: Abdominal contrast-enhanced CT exhibited a contrast effect along the liver capsule in the early contrast-enhanced phase, mainly in the right lobe of the liver (Figure 2).
case_images: PMC9972719_02
case_images: The technique of examination of the liver capsule irritation sign.. First, an abdominal examination is performed in the supine position (A). Next, the patient is placed in the left lateral decubitus, and the abdomen is palpated (B). A positive result is obtained when there is increased tenderness and spontaneous pain in the right upper abdomen. This figure depicts the procedure for evaluation of the liver capsule irritation sign in a normal male participant (not any of the patients from this study), to showcase the method employed for the two patients described in this study.
case_images: cureus-0015-00000034327-i01.jpg
case_images: PMC9972719_02_cureus-0015-00000034327-i01.jpg
case_images: FIG1
case_images: When the patient was placed in the left lateral recumbent position and the abdomen was palpated (as per the procedure described in Figure 1), tenderness and spontaneous pain increased in the right upper abdomen (liver capsule irritation sign).
case_images: Early phase of contrast-enhanced CT of the abdomen.. A contrast effect was observed along the liver capsule, mainly in the right lobe of the liver. CT: computed tomography.
case_images: cureus-0015-00000034327-i03.jpg
case_images: PMC9972719_02_cureus-0015-00000034327-i03.jpg
case_images: FIG3
case_images: Abdominal contrast-enhanced CT showed a contrast effect along the liver capsule in the early contrast phase, mainly in the right lobe of the liver (Figure 3), and a diagnosis of perihepatitis associated with Fitz-Hugh-Curtis syndrome was confirmed.