surgery cms form 5 #18

8. 27 year old primigravid woman at 28 weeks' gestation is admitted to the hospital 2 days after the onset of constant right upper abdominal pain. Reports decreased appetite, nausea and vomiting, and decreased fetal movement. No contractions, vaginal bleeding, abnormal vaginal discharge, or change in bowel movements. Her temperature is 38°C (100.4°F), pulse is 95/min, and blood pressure is 138/70 mm Hg. Physical exam is all normal except for tenderness in the right upper quadrant with voluntary guarding and no rebound. Bowel sounds are normal. Fundal height is 28 cm.

Laboratory studies show: Hemoglobin 12, Leukocyte count : 14,000/mm3, Platelet count : 140,000/mm3 , Prothrombin time : 12 sec, Serum Na+ : 142,  K+ : 4.5,  Cl : 104, Total bilirubin : 1.8, Alkaline phosphatase :268, AST : 40, ALT : 44, Urine Glucose : negative, urine protein : trace, urine Ketones : 2+

What is the diagnosis?

Abruptio placentae, Acute appendicitis, Acute cholecystitis, Acute fatty liver of pregnancy, Fitz-Hugh-Curtis syndrome

Answer is cholecystitis. The answer makes sense but how about fitz hugh curtis?