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 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 occurring in % to % of the population. In these patients, the colon is displaced and caught.

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Chilaiditi sign or syndrome. Abdominal ultrasound was unremarkable.

Chilaiditi’s Syndrome – NORD (National Organization for Rare Disorders)

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. The incidence of this syndrome ranges from 0. Such imaging techniques may include chest and abdominal x- rays, ultrasounds, or computerized tomography CT scanning. 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.

A year-old Caucasian female presented to the emergency department with a hour history of nausea and worsening epigastric and right upper quadrant pain.

By using this site, you agree to the Terms of Use and Privacy Policy. View at Google Scholar A. Abdominal pain, constipation, vomiting, respiratory distress, anorexia, volvulus, and obstruction are possible presentations of this syndrome [ 3 ].

Case 14 Case This condition occurs in 0. Chilaiditi sign is also referred to as hemidiaphragmatic interposition of the colon. Ansari H, Lay J. In these patients, the colon is displaced and caught between the liver and the right hemidiaphragm. Colonic interposition is usually an asymptomatic radiologic sign. Comparisons may be useful for a differential diagnosis. The exact cause is not always known, but it may occur in patients with a long and mobile colon dolichocolonchronic lung disease such as emphysemaor liver problems such as cirrhosis and ascites.


He was found to have Chilaiditi syndrome diagnosed by plain x-ray chest and abdomen and was confirmed with CT scan. Chilaiditi’s syndrome can cause a variety of symptoms including abdominal pain, nausea, vomiting, and small bowel obstruction. Chilaiditi syndrome has been known to cause severe complications including volvulus of the cecum, splenic flexure or transverse colon, cecal perforation, and subdiaphragmatic appendicitis perforation [ 4 ].

However, if Chilaiditi syndrome develops with severe complications, including mechanical bowel obstruction, mesentery ischemia, perforation, and peritonitis, emergent surgery must be considered. Case 7 Case 7. With normal human anatomy, the suspensory ligaments of the liver, mesocolon, liver, and the falciform ligament are situated in a manner that minimizes space surrounding the liver and prevents interposition of the colon.

Gastroenterol Hepatol N Y. An interposed segment of bowel can also make it very diffcult to perform a potentially dangerous complication that can lead to perforation [ 5 ]. Over a century ago, the radiologist Demetrius Chilaiditi reported a small case series of 3 patients with the incidental radiologic finding of colonic interposition between the liver and diaphragm.

From Wikipedia, the free encyclopedia. Laparoscopy was used in management some cases of Chilaiditi syndrome causing small bowel obstruction [ 14 ]. To receive news and publication updates for Case Reports in Surgery, enter your email address in the box below.

Howship—Romberg sign Hannington-Kiff sign. Confusions could be avoided with proper diagnosis of this rare syndromic presentation with more serious abnormalities such as perforated viscus, pneumoperitoneum and subphrenic abscess. Chilaiditi’s syndrome Colonic interposition. 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 and the livervisible on plain abdominal X-ray or chest X-ray.


Eponymous medical signs for digestive system and abdomen. He is not a diabetic or hypertensive.

Chilaiditi Syndrome

Case 11 Case Features that suggest a Chilaiditi syndrome i. Symptom-producing interposition of the colon. General Discussion Chilaiditi’s syndrome is a rare condition in which a portion of the colon is abnormally located interposed in between the liver and the diaphragm. Diagnosis is best achieved with CT imaging.

Clinical syndrome in mentally deficient adults. A repeat radiograph following bowel decompression may show disappearance of the air below the diaphragm. No intervention is required for syndromr asymptomatic patient with Chilaiditi sign. The sign can be permanently present, or sporadically.

Chilaiditi syndrome is extremely rare. 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. There was mild bowel wall thickening involving the mid-transverse colon and descending colon, but there was no evidence of bowel obstruction.

Case 6 Case chilaidifi.

The finding revealed transverse colon interposition between liver and right diaphragm Figure 1b. In rare cases, symptoms do develop; these cases are referred to as Chilaiditi’s syndrome. The occurrence incidence on abdominal or chest X-rays is around 0.