Friction sounds in the liver area are when the palm of the right hand is lightly pressed against the liver area during the examination and the patient is asked to perform abdominal breathing movements. There is no frictional sensation under the palm when normal. In perihepatitis, the surface of the liver and the adjacent peritoneum may become rough due to fibrinous exudate. The mutual friction between the two can be known by palpation, as the hepatic friction sensation, and as mentioned earlier, the sound heard during auscultation is the hepatic friction sound. So, what are the causes of hepatic friction sounds? Take a look below. 1, perihepatitis, is an inflammation of the liver peritoneum and subperitoneal connective tissue caused by gonococcal and Chlamydia trachomatis and other STD pathogens. Also known as FitZ a Hugh a CurtiS syndrome. The disease was first described by stajan in 1920. Subsequently CurtiS reported a link between lyre-like or fenestrated adhesions between the anterior part of the liver and the peritoneal wall and a coexisting gonococcal pelvic inflammatory disease. in 1934 Fit2 a Hugh reported 3 cases and demonstrated that perihepatitis was a complication of gonococcal infection. In 1970, it was concluded that gonococcal and chlamydial infections were the main causes of venereal perihepatitis. The pathogens of this disease are mainly gonococcus and Chlamydia trachomatis. The average age of onset is 15-25 years. 20% of acute tubal infections are complicated by venereal perihepatitis. Only a few cases have been reported in men. The onset of disease extends mainly from abdominal infection to the surface of the liver. The main routes of transmission are direct dissemination from peritoneal lesions, translymphatic transmission, and hematogenous transmission. 2. Cancer cells invade the liver surface and adjacent peritoneum, which may become rough due to the presence of fibrinous exudate causing friction sounds.