Abstract
Chilaiditi syndrome is a very rare disorder characterized by abdominal pain due to the entrapment of the colon between the liver and the diaphragm. However, it is rare to have bowel perforation as a complication of this syndrome with only 2 cases reported to date. In this article, we present the case of a 56-year-old woman with medical history of scleroderma who presents with abdominal pain and was found to have colonic perforation from Chilaiditi syndrome. She was also incidentally found to have cecal adenocarcinoma. Sometimes abdominal pain in patients with Chilaiditi syndrome may be more than benign and calls for increased attention from clinicians regarding this.
Highlights
Chilaiditi sign is the finding of bowel in between the liver and right diaphragm[1] and is usually an incidental finding on chest or abdominal radiographs.[2]
We present the case of a 56-year-old woman who presented with Chilaiditi syndrome and cecal perforation and was coincidentally found to have an ascending colon adenocarcinoma
A computed tomography (CT) scan revealed multiple loops of large bowel positioned between the liver and the right diaphragm indicative of Chilaiditi syndrome, cecal wall thickening (Figure 1), multiloculated pelvic abscess with droplets of air suggestive of peritonitis, and segmental distension of several loops of distal small bowel concerning for ileus or partial obstruction
Summary
Chilaiditi sign is the finding of bowel in between the liver and right diaphragm[1] and is usually an incidental finding on chest or abdominal radiographs.[2]. Chilaiditi sign is the finding of bowel in between the liver and right diaphragm[1] and is usually an incidental finding on chest or abdominal radiographs.[2] When it is associated with symptoms of entrapment, it is called Chilaiditi syndrome.[3] Symptoms include abdominal pain, distension, bloating, nausea, vomiting, flatulence, change in bowel habits, and rarely substernal pain, shortness of breath, or arrhythmias.[2] Very rarely is it associated with bowel perforation, and there are only 2 cases reported to date.[4,5] Here we present the case of a 56-year-old woman who presented with Chilaiditi syndrome and cecal perforation and was coincidentally found to have an ascending colon adenocarcinoma.
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