Chilaiditi Syndrome Research Articles

Chilaiditi sign.

Chilaiditi sign.

Chilaiditi syndrome with an unusual radiographic image: A crescent-shaped liver

Chilaiditi syndrome with an unusual radiographic image: A crescent-shaped liver

Successful treatment of an iatrogenic gastro-colo-cutaneous fistula in a patient with Chilaiditi syndrome: A case report

Chilaiditi syndrome is an occasional radiographic anomaly characterized by the interposition of the bowels between the liver and the diaphragm. The presence of Chilaiditi syndrome can cause serious...

Chilaiditi syndrome.

Chilaiditi syndrome.

Differentiating Chilaiditi signs from Chilaiditi syndrome

Differentiating Chilaiditi signs from Chilaiditi syndrome

Chilaiditi syndrome with eventration of the diaphragm: A rare coexistence

Simultaneous coexistence of Chilaiditi syndrome along with eventration of the diaphragm is a rare occurrence. We present a case of this rare occurrence in a 41 year old male patient who presented with respiratory distress.

Medical image of the week: Chilaiditi syndrome

Medical image of the week: Chilaiditi syndrome

Chilaiditi Sign: A Rare Incidental Finding

Chilaiditi sign is an incidental radiologic finding that presents as a crescent lucency below the right diaphragm due to malpositioned loops of the colon or small bowel. It is extremely rare, occurring in 0.025% to 0.28% of the general population. It is usually benign but can lead to various life threatening complications including obstruction, perforation, or ischemia. It is therefore important to recognize this sign and proceed with timely management. An 80 year old male with history significant for diabetes mellitus, atrial fibrillation, and hypertension presented with complaints of intermittent right-sided pleuritic chest pain and productive cough for one week. On presentation, patient was tachycardic, tachypnic, afebrile, normotensive, and on room air. Chest x-ray showed pneumonia, fractures of the right 6th and 7th ribs, and incidentally, presence of gas below the right diaphragm. Due to this alarming finding, patient was reassessed. He reported regular bowel movements without nausea or vomiting, had active bowel sounds, and no signs of acute abdomen. As this finding was inconsistent with the clinical condition, Chilaiditi was considered. CT abdomen confirmed diagnosis of Chilaiditi syndrome with hepatodiaphragmatic interposition of the colon. Patient was discharged on Levofloxacin and pain control for pneumonia and fractures respectively. Incidental findings were appropriately documented to prevent extensive retesting in the future. Our case illustrates the incidental sign of Chilaiditi. It is due to the anterior interposition of the colon to the liver and is a cause of pseudopneumoperitoneum. The absence of pain, nausea, vomiting, and abdominal distention distinguishes Chilaiditi sign from its counterpart, Chilaiditi syndrome. The exact mechanism is unknown but thought to be from a wide space between the liver and the diaphragm. This could be from liver scarring, ascites, diaphragmatic weakness, laxity of ligaments, abnormal colon mobilization, constipation, obesity, or increased intraabdominal pressure. Further imaging must be obtained if Chilaiditi sign is found. If there is evidence of ischemic bowel, volvulus, obstruction, or perforation, surgical treatment should be pursued. Chilaiditi sign occurs in 1 in 50,000 adults and therefore is not widely taught or recognized. Though it is generally benign, it can be a sign of a life-threatening condition. Prompt recognition and early therapy are quintessential to prevent fatal complications.Figure 1

Triple-X syndrome accompanied by Chilaiditi syndrome in preterm infant: a case report

Chilaiditi syndrome is a variant of the rotation of the colon that gives rise to the interposition of the colon between the right diaphragm and the liver intermittently or constantly. Also, Necrotizing enterocolitis is typically seen in premature infants. In this report, we presented a female case report accompanied with a 47,XXX karyotype and Chialiditi syndrome and Necrotizing enterocolitis. This association was not reported in any case study. Our findings suggest that abnormalities of X chromosome may be associated with other anomalies.

Chilaiditi's sign

Chilaiditi's sign

Chilaiditi's sign

A 79-year old male with a history of diabetes mellitus and systemic hypertension was admitted with cough and fever through the outpatient department of our hospital. In spite of his advanced age he was ambulant without support and led an active life. He neither smoked nor consumed alcohol and was married for many years. Clinical examination revealed the presence of decreased breath sounds in the right infrascapular area and lower part of both the right axillary andmammary

Complicated adult right-sided Bochdalek hernia with Chilaiditi's syndrome: a case report.

An extremely rare adult case that underwent surgery for ileus caused by Bochdalek hernia associated with Chilaiditi’s syndrome is presented. A 65-year-old woman complaining of upper abdominal pain presented to our hospital. Abdominal plain radiography showed increased intestinal gas, and computed tomography (CT) showed the transverse colon located above the right lobe of the liver, representing Chilaiditi’s sign. She was diagnosed as having ileus and treated with decompression therapy by a nasoenteric tube. After hospitalization, the patient developed dyspnea, and CT showed intestinal herniation into the right thoracic cavity. She was diagnosed as having strangulated ileus caused by Bochdalek hernia. An emergent laparotomy was performed, and it showed a hole of 5 cm in diameter at the right hemi-diaphragm. The transverse colon was incarcerated through the hole, it was pulled back to the abdominal cavity, and a right hemicolectomy was performed because of necrotic changes. A small part of the liver was also herniated into the right thoracic cavity, and it was returned to the abdominal cavity. The defect in the diaphragm was closed by direct suture. Although the patient developed an abscess in the thoracic cavity postoperatively, she improved with antibiotic therapy and was discharged 2 months after the operation.

Recognizing the Acquired Chilaiditi Syndrome and Managing It With Novel Therapy

Recognizing the Acquired Chilaiditi Syndrome and Managing It With Novel Therapy

Is pneumoperitoneum the terra ignota in ultrasonography?

In most cases, pneumoperitoneum is caused by gastrointestinal perforation, which usually requires surgical treatment. Many authors believe that ultrasound imaging of pneumoperitoneum is at least as effective as conventional radiography, or even that its efficacy is superior. In such a situation, it is imperative to make this modality one of the main tools in the diagnostic arsenal of emergency medicine. This is the main aim of this paper. First, ultrasound anatomy of so-called thoracic-abdominal border is discussed. The equipment requirements emphasize that the diagnostic process can be conducted with the simplest portable US scanner, even without the Doppler mode. The technique of a US examination, the aim of which is to detect, free air in the peritoneal cavity is also simple and conducted with the patients lying down, either in the supine or lateral position. A convex transducer with the frequency of 3.5–5 MHz is applied above the lower intercostal spaces on the right and left side, to the epigastric region below the xiphoid process and in various sites of the abdominal wall. The most effective examination, however, is conducted in the left lateral position via the right intercostal spaces. The differential diagnosis on the right side under the diaphragm should include the presence of a subdiaphragmatic abscess with gas and a hepatic abscess with a similar content as well as transposition of the colon in between the diaphragm and the liver (Chilaiditi syndrome). It seems that the inclusion of a US examination to the E-FAST method in order to detect free gas in the peritoneal cavity is justified since it is a sign of gastrointestinal perforation in numerous cases, and is clinically as relevant as the presence of free fluid.

Anterior hepatic grooves accompanied by Chilaiditi sign: a retrospective radiological analysis of a neglected anatomical fact.

To evaluate anterior hepatic grooves (AHGs) associated with hepato-diaphragmatic mesocolic indentations (Chilaiditi sign) and to delineate the incidence and potential clinical significance of this association. Between November 2011 and June 2014, abdominal computed tomography examinations of 2,314 patients with varied indications were retrospectively reviewed. Patients were surveyed consecutively for the Chilaiditi sign and syndrome, and cases with grooves at the antero-inferior hepatic surface enclosing the adjacent mesocolic indents were determined. The incidence of AHGs and their predominance by gender and age were determined. The potential clinical significance of AHGs associated with Chilaiditi syndrome and their possible effect on liver volume were assessed. The incidences of AHGs were similar between genders (p=.461 and p=.646) and age (p=.113 and .621, respectively) among total cohort and patients with Chilaiditi sign, respectively. There was no significant correlation between AHGs and Chilaiditi syndrome (p=.506); no efficacies of AHGs to liver volume were assessed (p=.413). The AHGs are rare adaptive changes in shape of the liver without a significant effect on liver volume. This overlooked phenomenon is likely derived from the Chilaiditi sign, but has no significant correlation with Chilaiditi syndrome. Future studies with extended series are encouraged to reveal the possible significance of this phenomenon based on concerned surgical interventions.

Chilaiditi's Sign in a Patient on Peritoneal Dialysis

A 87-year-old gentleman with end stage renal failure on peritoneal dialysis presented to the emergency department for sudden onset shortness of breath. A chest x-ray was obtained, revealing apart from a left sided pneumothorax, there was alarmingly a gas density under the right hemidiaphragm. It is diagnosed as Chilaiditi's sign in a peritoneal dialysis patient.

Bir çocuk hastada Chilaiditi Sendromu: vaka sunumu

Chilaiditi syndrome is a rare disease which is characterized by recurrent abdominal pain, respiratory distress, constipation, and vomiting. It is usually asymptomatic, and the anomaly is diagnosed incidentally on chest or abdominal radiographs. The radiographs show interposed segment of colon or small bowel between the right lobe of the liver and the diaphragm. Treatment is not required for asymptomatic cases. In symptomatic patients, the initial treatment is conservative. Surgical treatment is performed in patients with obstruction, colonic volvulus or perforation. Beeing a rare syndrome in pediatric patients, we aimed to present an 8 year old female patient diagnosed as Chilaiditi syndrome, who has chronic abdominal pain, vomiting, and cough. Key words: Chilaiditi syndrome, children, abdominal pain, colopexy

Chilaiditi sign: A rare differential diagnosis of gas under diaphragm

Chilaiditi sign: A rare differential diagnosis of gas under diaphragm

A Rare Cause in The Differantial Diagnosis of Chilaiditi Syndrome: A Peptic Ulcer Perforation

A Rare Cause in The Differantial Diagnosis of Chilaiditi Syndrome: A Peptic Ulcer Perforation

A rare cause of renal colic pain: Chilaiditi syndrome.

Chilaiditi syndrome, first described in 1910 by the radiologist Chilaiditi from Vienna, is the interposition of right colon between liver and right hemi diaphragm. It occurs most often in males and its incidence increases with age. It is often detected incidentally during radiological examination. It's rarely symptomatic; symptoms can differ from mild abdominal pain to severe acute intestinal obstruction. Our case applied to emergency service with right flank pain. There was no calculus or dilatation in the urinary system at non-contrast abdominopelvic computerized tomography. Ascending colon was interposed between liver and diaphragm so that the patient was diagnosed as Chiliaditi syndrome. The patient was treated conservatively and discharged with dietary suggestions by the gastroenterology consultant. The conclusion of this report is that the Chilaiditi syndrome must be considered in differential diagnosis for patients presenting with urinary colic pain symptoms with no urinary pathology on radiologic imaging.