Chilaiditi Syndrome Research Articles

Chilaiditi Syndrome: An Incidental Finding on a Chest Radiograph in a Long-Term Ventilated Patient

Background: Chilaiditi syndrome is a situation with a structural impingement of the colon on the liver, leading to an elevated hemidiaphragm in the X-ray along with a gas-like ap-pearance in the right hemithorax. It is generally a benign disease that is managed conservatively upon diagnosis. Rarely, it can be a cause of intestinal obstruction. Chilaiditi syndrome was origi-nally named after Demetrius Chilaiditi, the Greek radiologist who first described the case in 1910 while working in Vienna. Case Presentation: Here, we have described the case of a 76-year-old male who was admitted to our long-term care facility for chronic respiratory failure, and he was connected to mechanical ventilation via tracheostomy. He was having occasional bouts of constipation, and was on regular laxatives. In a CT chest film done because of very thick respiratory secretions and desaturation, an incidental finding of Chilaiditi syndrome was noted. : The patient has been managed conservatively with laxatives and per-need enemas. : Chilaiditi syndrome is a rare condition in which the colon interposes between the liver, right hemidiaphragm, and the abdominal wall, causing occasional clinical symptoms. Conversely, radiographic findings without clinical symptoms are known to exhibit the Chilaiditi sign. The disease's prevalence is estimated to be somewhere between 0.025 and 0.28%. Conclusion: Chilaiditi syndrome is a syndrome that refers to the interposition of the colon upon the hepatic flexure. It is a very rare but a serious cause of constipation, resulting in severe symptoms to the extent that they may warrant surgical intervention.

Overlap of Chilaiditi syndrome and diaphragmatic paralysis: a rare case.

Overlap of Chilaiditi syndrome and diaphragmatic paralysis: a rare case.

Chilaiditi Syndrome: A Rare Case of Diaphragmatic Interposition and its Multidisciplinary Management

Chilaiditi Syndrome: A Rare Case of Diaphragmatic Interposition and its Multidisciplinary Management

Acute Abdominal Pain Revealing Chilaiditi Syndrome

Chilaiditi sign is a rare phenomenon characterized by the radiological observation of segmental interposition of the colon or small intestine between the liver and the diaphragm. It may manifest asymptomatically or be accompanied by a range of clinical symptoms, from mild abdominal pain to acute intestinal obstruction. When symptoms are present, it is termed Chilaiditi syndrome. Typically, management of Chilaiditi syndrome is conservative; however, surgery may be necessary in cases of complications or failure of conservative therapy.

Chilaiditi Syndrome - A Case Report of Pseudopneumoperitoneum

Pneumoperitoneum presents a crucial diagnostic indicator, dictating the immediacy of patient management within an emergency department. Chilaiditi's sign denotes an uncommon radiological discovery characterized by the transposition of the large intestines between the diaphragm and the liver. Should symptoms arise in the patient, this condition is referred to as Chilaiditi syndrome. We report a unique instance involving a 77-year-old female who visited our emergency department with complaints of chest and abdominal pain. Upon radiological evaluation through chest radiograph and computed tomography scan, she was diagnosed with Chilaiditi syndrome. Instead of opting for invasive and potentially unnecessary diagnostic and therapeutic procedures, she was managed conservatively. This approach was chosen to mitigate the risk of heightened morbidity associated with unwarranted interventions. This case report delves into Chilaiditi syndrome, aiming to enhance the understanding of healthcare practitioners regarding this condition. Emphasizing the significance of thorough physical examinations in assessing patients presenting with apparent signs of air under the diaphragm is a key focus of this review. Keywords: Pneumoperitoneum, Chilaiditi, Pseudopneumoperitoneum.

Bilateral Chilaiditi Syndrome in a Nigerian Child with Severe Acute Malnutrition: A Case Report

Abstract
 Chilaiditi syndrome is characterised by abdominal pain, usually in the right upper quadrant, associated with a radiological finding of sub-diaphragmatic free air due to colonic interposition between the diaphragm and the liver. The Chilaiditi sign is the radiological finding of sub-diaphragmatic pneumoperitoneum due to colonic interposition between the diaphragm and the liver without any clinical symptom. It can be a source of diagnostic dilemma considering bowel perforation as a common differential leading to unnecessary exploratory laparotomy.
 We report a four-year-old boy who presented with abdominal pain, fever, abdominal distension and diarrhoea with intermittent long-standing constipation. A plain abdominal radiograph in the erect position showed bilateral sub-diaphragmatic free air with associated haustration markings in free air. He was managed conservatively with antibiotics and nutritional rehabilitation with remarkable clinical improvement. While evaluating a child with an acute abdomen, the radiographic finding of free sub-diaphragmatic air, which is discordant with clinical signs, should heighten the suspicion of Chilaiditi syndrome. Knowledge of Chilaiditi syndrome is essential to avoid unnecessary surgical intervention while considering bowel perforation as a common cause of sub-diaphragmatic air.

The role of ultrasound in the diagnosis of Chilaiditi syndrome

The role of ultrasound in the diagnosis of Chilaiditi syndrome

Pyloric Stenosis Syndrome Revealing Chilaiditi Syndrome

Chilaiditi syndrome is a radiological manifestation of a large bowel interposition between the liver and right hemidiaphragm that associated with gastrointestinal symptoms, We report a case of 50-year-old woman with no particular pathological history who presented to the emergency room with a presentation of pyloric stenosis, The presence of Chilaiditi signs can be caused by an abnormality of either liver, colon or right hemidiaphragm that leads to sub-diaphragmatic space enlargement or intestinal hypermobility. Computed tomography imaging is the best diagnostic modality. Conservative treatment is the first line in management.

Two Cases of Chilaiditi Syndrome: Symptomatic and Asymptomatic Presentation

Two Cases of Chilaiditi Syndrome: Symptomatic and Asymptomatic Presentation

An Atypical Case of Myxedema Coma with Incidental Chilaiditi Syndrome

• Hypothyroidism is a prevalent condition in the general population.1 42 million people in India have thyroid disorders and hypothyroidism is the most common, affecting one in ten adults. • Myxedema coma is a rare and life threatening emergency with a high mortality rate.2 It results from severe hypothyroidism and affects almost every organ • Patients will present with myxedema coma, characterized by hypothermia, hypotension, bradycardia, and altered mental status in the setting of severe hypothyroidism.3 Myxedema coma has also been known to manifest in a number of unusual and dangerous forms. • A high index of suspicions is needed among clinicians in order to rapidly recognize the condition and make an early diagnosis. Treatment should be commenced on clinical grounds while waiting for laboratory results. • Here, we present the case of a male who presented to the emergency department with altered mental status, Anasarca and in abilty to walk.

A rare case of asthmatic patient with left Chilaiditi's syndrome.

The following case report aims to highlight the rarity of the case in question, in which there is left Chilaiditi syndrome in a patient with bronchial asthma. The patient is a 79-year-old woman who arrived in January 2023 at my facility for episodes of recurrent dyspnea, chest heaviness, wheezing, eructation, dysphagia, epigastric abdominal pain associated with frequent episodes of bronchitis. He performed simple spirometry which showed mixed mild-moderate ventilatory deficit with reduction of small airway volumes, reduced peak expiratory flow and negative broncho reversibility tests for asthma. At 3 months, the patient returned to my attention with a chest radiograph showing marked elevation of the left hemidiaphragm with deviation of the cardiac shadow to the right. He repeated the spirometry which resulted in a clear improvement compared to the previous control with an important variation of the peak respiratory flow during ICS/LABA, the objective finding previously found disappeared, this indicating the presence of an underlying bronchial asthma. The radiological picture was identified by me as Left Chilaiditi Syndrome, as the patient had gastrointestinal symptoms which accompanied the procession of respiratory symptoms. The diagnostic suspicion must be early in these pathologies and the proton pump inhibitors and new generation alginates with the presence of hyaluronic acid and melatonin must also be included in the treatment of the symptoms, which have an important action on gastroesophageal reflux disease (GERD) secondary to this herniation of the viscera into the thoracic cavity. The rarity is represented by the left localization of the diaphragmatic pathology.

Chilaiditi Syndrome: A Case Report, Literature Review, and Proposition of a Novel Management Staging System

Chilaiditi Syndrome: A Case Report, Literature Review, and Proposition of a Novel Management Staging System

S2317 Chilaiditi Syndrome: A Rare Case of Recurrent Chest Pain Due to Colonic Interposition

S2317 Chilaiditi Syndrome: A Rare Case of Recurrent Chest Pain Due to Colonic Interposition

S4013 Chilaiditi Syndrome Masquerading as Acute Cholecystitis

S4013 Chilaiditi Syndrome Masquerading as Acute Cholecystitis

An Incidental Finding of Chilaiditi's Sign: A Case Report

Chilaiditi’s Sign is a rare radiographic finding in which there is an interposition of the colon between the diaphragm and the liver. The etiology is multifactorial and can be divided into diaphragmatic, hepatic, and colonic causes. Chilaiditi’s sign is considered a cause of pseudo-pneumoperitoneum. On imaging, the sign can easily be misdiagnosed as a ‘true’ pneumoperitoneum, causing the patient to undergo unnecessary investigations and interventions. This case report presents an 88-year-old male with a past medical history of Ischemic Heart Disease (IHD) and Hypertension (HTN) who presented to the Emergency Department (ED) with a clinical picture of obstructive jaundice and was admitted for an Endoscopic Retrograde Cholangiopancreatography (ERCP). Post-ERCP, the patient complained of chest pain, in which a chest X-ray was done, and Chilaiditi’s sign was found.

A case report: Anaesthetic management of a patient with sub acute intestinal obstruction with chilaiditi syndrome coming for surgery

Chilaiditi syndrome is associated with hepatodiaphragmatic interposition of the colon and the small intestines. The radiological finding of colonic interposition between the liver and diaphragm is called chilaiditi sign. This is a rare anomaly incidentally seen on chest or abdominal radiographs. We present a case report of a 52 year old male who got admitted with complaints of abdominal distension and occasional pain after food intake for 5 months duration. The pain was dull aching and not radiating. He gave history of weight loss of about 10 kg over 5 months. His mother had similar complaints of dull aching abdominal pain of which she died. X ray chest showed gross dilatation of descending and transverse colon causing mediastinal shift to right. The CT chest showed emphysematous bullae on the left lobe. The working diagnosis of Chilaiditi syndrome was made. The patient came for surgery with subacute intestional obstruction. Here, in this case report we discuss the anaesthetic management.

Biliary Obstruction Secondary to Chilaiditi Syndrome.

Biliary Obstruction Secondary to Chilaiditi Syndrome.

Scleroderma Associated with Chilaiditi Syndrome: Case Report

Chilaïditi syndrome corresponds to the interposition, most often asymptomatic and temporary, of the intestine between the upper surface of the liver and the right diaphragmatic dome. It is characterized by the association of radiological semiology and various digestive manifestations, acute or chronic abdominal pain, intermittent sub-occlusions, nausea, vomiting, transit disorders, and rare intestinal occlusive complications. We report through this observation a case of a patient whose chilaiditi syndrome was the mode of revelation of her scleroderma.

Laparoscopic treatment of small bowel obstruction caused by Chilaiditi syndrome in an elderly patient: a case report

Laparoscopic treatment of small bowel obstruction caused by Chilaiditi syndrome in an elderly patient: a case report

Male with abdominal distention and abnormal chest x-ray.

A 48-year-old man receiving chemotherapy for glioblastoma multiforme presented for generalized weakness and fecal incontinence, which he described as “dribbling drops” of liquid stool. Physical examination showed dry mucous membranes, bowel sounds in the right upper quadrant, diffuse abdominal tenderness without peritoneal signs, suprapubic fullness, and a large amount of clay-like stool in the rectal vault. Dehydration was suggested by sodium of 148 mmol/L and osmolarity of 313 mOsm/kg on serum chemistries. Chest radiograph (Figures 1 and 2) was obtained, followed by computed tomography (Figure 3). Chilaiditi's sign occurs when the bowel is interposed between the right hemidiaphragm and the liver. It occurs in less than 1% of the population and is more common in elderly males and those with chronic constipation, cirrhosis, obesity, or chronic lung disease.1 When symptoms of abdominal pain, nausea, vomiting, or respiratory distress occur, it is known as Chilaiditi's syndrome. Our patient was admitted for serial abdominal examinations, and he responded to conservative management with bladder decompression with Foley catheter and enemas. Surgery may be required if obstruction, volvulus, or bowel ischemia is suspected. Chilaiditi's sign is an important mimic of pneumoperitoneum. Haustral markings may be seen on plain films. Inverting the image or changing the penetration may assist in visualizing haustra. Air will not move if the patient is repositioned for additional images. Computed tomography is diagnostic. Distinguishing factors on ultrasound have also been described.2