Chilaiditi′s syndrome masquerading as chest pain

Abstract

Chilaiditi syndrome is a condition in which the colon or rarely the small bowel is interposed temporarily or permanently between the liver and the diaphragm. Usually it is an asymptomatic and incidental radiographic finding, but may present with a variety of symptoms. We report a case of Chilaiditi syndrome with small bowel interposition who presented with chest pain, initially suspected to be myocardial infarction. Further Investigations revealed normal cardiac functions and gas under the right hemidiaphragm suggestive of pneumoperitoneum. After careful inspection of radiograph it was found to be gas filled small bowel between liver and diaphragm, which was later confirmed by ultrasound examination. The patient was successfully managed conservatively.