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 when pain occurs due to transposition of a loop of large intestine (usually transverse colon) in between the diaphragm. Chilaiditi syndrome is the interposition of the colon between the liver and the right hemidiaphragm. The incidence of this syndrome ranges from % to %.

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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.

When no symptoms are present, this clinical finding is referred to as Chilaiditi’s sign.

Comparisons may be useful for a differential diagnosis. This article has sindromw cited by other articles in PMC. Clin Exp Nephrol ; Complications of Chilaiditi syndrome may include a volvulus chiliaditis the cecum, splenic flexure, or transverse colon.

He was then allowed to take regular diet gradually after 6hours, he tolerated oral feeds and sindroome discharged later without any significant symptoms.

How to cite this URL: Colonic interposition between the liver and left diaphragm – management of Chilaiditi syndrome: Case 7 Case 7. In recent years, surgical intervention has been increasingly used in order to manage symptoms of chronic, intermittent abdominal pain [ 6 ]. She did not recall having a similar experience before. Chilaiditi syndrome should be considered as a rare cause of intestinal obstruction of either the large or small bowel, as reported by Mateo de Acosta Andino and associates.


Chest X-ray showing obvious Chilaiditi’s sign, or presence of gas in the right colic angle between the liver and right hemidiaphragm.

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Chilaiditi syndrome can be a self-resolving or a chronic condition [ 4 ]. Receive exclusive offers and updates from Oxford Academic. If the patient is symptomatic, treatment is usually conservative. None, Conflict of Interest: Chilaiditi’s sign in a child with nephrotic syndrome.

Fothergill’s sign Carnett’s sign. Laparoscopy was used in management some cases of Chilaiditi syndrome causing small bowel obstruction [ 14 ]. This entity was first described by Demetrius Chilaiditi in Initial management of Chilaiditi syndrome should include bed rest, intravenous fluid therapy, bowel decompression, enemas, and laxatives. Articles Cases Courses Quiz. Case 16 Case A repeat radiograph following bowel decompression may show disappearance of the air below the diaphragm.

Goodsall’s rule Sinsrome syndrome intussusception: A Xhilaiditis scan was showed what was believed sinrdome be a section of colon that had herniated through the diaphragm. Views Read Edit View history. This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

He had no surgeries in the past. Further imaging by CT scan of the thorax, abdomen, and pelvis showed a loop of colon interpositioned between the liver and right hemidiaphragm, mimicking free air Figure 1.

Peritonitis Spontaneous bacterial peritonitis Hemoperitoneum Pneumoperitoneum. He was found to have Chilaiditi syndrome diagnosed by plain x-ray chest and abdomen and was confirmed with CT scan. Eur J Pediatr Surg.

Chilaiditi’s syndrome masquerading as chest pain Goel A, Dewanda NK – J Sci Soc

Administration of carbon dioxide as the insufflating agent for colonoscopy is appropriate for decreasing this risk. This page was last edited on chiladiitis Aprilat There were no signs of rebound tenderness, guarding, or ascites. Case Presentation A year-old Caucasian female presented to the emergency department with a hour history of nausea and worsening epigastric and right upper quadrant pain.


The Chilaiditi syndrome and associated volvulus of the transverse colon. An elderly man with chest pain, shortness of breath, and constipation. Malavade V, Udyavar A. Confusions could be avoided with proper diagnosis of this rare chilauditis presentation with more serious abnormalities such as perforated viscus, pneumoperitoneum and subphrenic abscess.

Chilaiditi is a rarely considered differential diagnosis with vague symptoms that make diagnosis difficult. Coeliac Tropical sprue Blind loop syndrome Small bowel bacterial overgrowth syndrome Whipple’s Short bowel syndrome Steatorrhea Milroy disease Bile acid malabsorption. CT view demonstrate a loop of colon interpositioned between the liver and right hemidiaphragm.

His family history was significant for hypertension. However, variations in normal anatomy can lead to the pathologic interposition of the colon. Both demonstrate a loop of colon interpositioned between the liver and right hemidiaphragm. In simdrome case it was complicated by megacol on progressed to heart failure casing death.

Citing articles via Web of Science 1. Acquired risk factors include chronic chilaiitis, cirrhosis leading to liver atrophy, obesity, multiple pregnancies, ascites, and paralysis of the right diaphragm [ 4 ]. CT can clearly demonstrate the presence of interposed colonic loops between the right hemidiaphragm and liver with no free intraperitoneal air.