Chilaiditi syndrome is a rare condition when pain occurs due to transposition of a loop of large intestine (usually transverse colon) in between the diaphragm. Chilaiditi syndrome is the anterior interposition of the colon to the liver reaching the under-surface of the right hemidiaphragm with associated upper abdominal. Chilaiditi syndrome is a rare condition occurring in % to % of the population. In these patients, the colon is displaced and caught.

Author: Nagor Kezahn
Country: Zimbabwe
Language: English (Spanish)
Genre: Music
Published (Last): 27 October 2011
Pages: 267
PDF File Size: 8.11 Mb
ePub File Size: 2.8 Mb
ISBN: 728-8-14977-744-7
Downloads: 22724
Price: Free* [*Free Regsitration Required]
Uploader: Nesar

The diaphragm is the muscle that separates the chest cavity from the abdomen. However, variations in normal anatomy can lead to the pathologic interposition chipaiditi the colon. Case 6 Case 6. Chest X-ray Figure 1a and 1b showed air under right hemidiaphragm but plain abdominal X-ray left lateral decubitus position did not show free intraperitoneal air. The patient synerome then diagnosed with Chilaiditi sign, which could have been managed conservatively [ 1 ].

In this case, the gallbladder position is often anomalous as well — it is often located anterior to the liver, rather than posterior. Standard Therapies Treatment The treatment of Chilaiditi’s syndrome is directed toward the specific symptoms that are apparent in each individual. If the patient is symptomatic, treatment is usually conservative. No particular family history, including cancer or chilaiditk disease, was traced from the interview.

This is by virtue of the fact that a syndrome is a collection of signs and symptoms. Chilaiditi syndrome is extremely rare. Case 16 Case If the patient is symptomatic, treatment is chialiditi conservative. In recent years, surgical intervention has been increasingly used in order to manage symptoms of chronic, intermittent abdominal pain [ 6 ].

Chilaiditi syndrome | Radiology Reference Article |

Lekkas CN, Lentino W. Chilaiditi syndrome Chest X-ray showing obvious Chilaiditi’s sign, or presence of gas in the right colic angle between the liver and right hemidiaphragm. Chilaiditi syndrome can be a self-resolving or a chronic condition [ 4 ]. Colonic interposition is usually an asymptomatic radiologic sign.


CT can clearly demonstrate the presence of interposed colonic loops between the right hemidiaphragm and liver with no free intraperitoneal air. Chilaiditi sign is also referred to as hemidiaphragmatic interposition of the colon. Kamiyoshihara presents a case where after a traffic accident, a 75 year old is believed to have developed a traumatic diaphragmatic hernia. Acquired risk factors include chronic constipation, cirrhosis leading to liver atrophy, obesity, multiple pregnancies, ascites, and paralysis of the right diaphragm [ 4 ].

Both demonstrate a loop of colon interpositioned between the liver and right hemidiaphragm.

Chilaiditi is a rarely considered differential diagnosis with vague symptoms that make diagnosis difficult. Over a century ago, the radiologist Demetrius Chilaiditi reported a small case series of 3 patients with the incidental radiologic finding of colonic interposition between the liver and diaphragm.

He was found to have Syndeome syndrome diagnosed by plain x-ray chest and abdomen and was confirmed with CT scan. You can also scroll through stacks with your mouse wheel or the keyboard arrow keys.

We hereby present a rare case of a year-old Omani male patient who was referred to us while admitted in Coronary Care Unit as a case of myocardial Infarction. Chilaiditi syndrome can be initially misdiagnosed as a diaphragmatic hernia. Posteroanterior chest radiography revealed the presence of air below the right side of the diaphragm Figure 1a.

There were no signs of rebound tenderness, guarding, or ascites.

It is important to identify Chilaiditi sign in order to prevent complications from occurring during a percutaneous transhepatic procedure or liver biopsy, particularly in cirrhotic patients, who are predisposed to development of Chilaiditi sign. Gastroenterol Hepatol N Y. Pneumoperitoneum is the abnormal presence of gas or air within the abdominal cavity. Another indication of Chilaiditi sign is when a patient changes positions, the area of radiolucency will not shift as seen in free air [ 4 ].


Differentials of Chilaiditi syndrome include bowel obstruction, volvulus, intussusception, ischemic bowel, appendicitis, and diverticulitis [ 4 ]. Peritoneum Blumberg syndrme Rigler’s sign Cupola sign. Case 10 Case This finding is a rare anomaly incidentally seen on chest or abdominal radiographs, with an incidence of 0. Sydnrome may be adequate to eliminate the possibility of recurrence in an uncomplicated cecal volvulus, unless gangrene or perforation necessitates surgical resection.

Surgery is rarely indicated with indications including ischemia and failure of resolution with conservative management. The specific symptoms that occur depend upon the cause.

Support Center Support Center.

Chilaiditi syndrome

In addition, Chilaiditi syndrome has been linked with pulmonary and gastrointestinal malignancies [ 4 ]. A year-old man presented to our emergency department because of progressive epigastric pain to right upper quadrant pain, nausea, and vomiting that had persisted for 2 days.

Report of three cases. The patient was managed conservatively with IV fluid hydration and pain management. Local examination of respiratory, cardiac system revealed nothing significant.

Chilaiditi’s Syndrome – NORD (National Organization for Rare Disorders)

Pain distinguishes Chilaiditi syndrome from asymptomatic colonic interposition, which is termed as Chilaiditi sign. A patient is predisposed to Chilaiditi syndrome when there is deviation of the structures surrounding the liver. Absence or laxity of the ligament suspending the transverse colon or of the falciform ligament are also thought to contribute to the condition.

Articles Cases Courses Quiz. Some affected individuals may not require any therapy. Decreased bowel sound was also present. The specific symptoms and presentation of Chilaiditi’s syndrome can vary greatly from one person to another. Her cardiac enzymes and urinalysis were unremarkable. Blumberg sign Rigler’s sign Cupola sign.