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.

Author: Kigarr Voodoogor
Country: Egypt
Language: English (Spanish)
Genre: Automotive
Published (Last): 28 October 2018
Pages: 97
PDF File Size: 9.70 Mb
ePub File Size: 14.78 Mb
ISBN: 918-8-73402-783-2
Downloads: 90301
Price: Free* [*Free Regsitration Required]
Uploader: Vudozil

Abstract Chilaiditi syndrome is a rare condition occurring in 0. Chest X-ray showing obvious Chilaiditi’s sign, or presence of gas in the right colic angle between the liver and right hemidiaphragm. Absence or laxity of the ligament suspending the transverse colon or of ssyndrome falciform ligament are also thought to contribute to the hcilaiditi. If the patient does not respond to initial conservative management, and either the obstruction fails to resolve or there is evidence of bowel ischemia, then surgical intervention is indicated.

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

Some affected individuals may not require any therapy. Surgical techniques that have been used to treat individuals with Chilaiditi’s syndrome include the removal of a portion of the colon transverse colectomy or right hemicolectomy or the anchoring of a displaced liver to the abdominal wall hepatopexy.

However, as mentioned above, these intestinal disorders can also occur within the interposed colon in rare instances. Predisposing congenital abnormalities include absent suspensory or falciform ligaments, redundant colon, malpositions, dolichocolons, and paralysis of the right diaphragm [ 14 ].

Chilaiditi sign or syndrome. These symptoms can occur together in a wide variety of different combinations. The patient was then diagnosed with Chilaiditi sign, which could have been managed conservatively [ 1 ]. In summary, abdominal pain with subphrenic free air does not always indicate surgical emergency.


IInformation on current clinical trials is posted on the Internet at www. Abdominal ultrasound was unremarkable.

To receive news and publication updates for Case Reports in Surgery, enter your email address in the box below. This sign was first described in the medical literature in by the Greek radiologist Demetrius Chilaiditi [ 2 ]. Chilaiditi syndrome and associated caecal volvulus. The patient was managed conservatively, nothing per month for 6 hours with analgesics and bed rest. Identification of Chilaiditi syndrome is clinically significant as it can lead to many significant complications such as volvulus, perforation, and bowel obstruction.

Blumberg sign Rigler’s sign Cupola sign. Case Reports in Surgery. These anatomic variations can include the absence, laxity, or elongation of the suspensory ligaments of the transverse colon or the falciform ligament, as well as dolichocolons or congenital malpositions.

Case Reports in Surgery

Chilaiditi syndrome is the anterior interposition of the colon to the liver reaching the under-surface of the right hemidiaphragm with associated upper abdominal pain; it is one of the causes of pseudopneumoperitoneum.

Additional predisposing factors include abnormal elongation of the colon or abnormal looseness laxity of certain ligaments of the colon and liver.

Recognition of Chilaiditi syndrome is important because this rare entity can be misleading to the surgeons and mistaken for more serious abnormalities, which synddome lead to unnecessary surgical interventions. Symptom-producing interposition of the colon.

Peritoneum Blumberg sign Rigler’s sign Cupola sign. Investigational Therapies IInformation on current clinical trials is posted on the Internet at www. A radiologic finding of hemidiaphragmatic interposition of the colon is referred to as Chilaiditi sign, while a symptomatic case is known as Chilaiditi syndrome.

Chilaiditi syndrome refers only to complications in the presence of Chilaiditi’s sign. A Complete blood count demonstrated a normal study. Intensivists referred him to General surgery as they detected a suspicious presence of gas under the diaphragm pneumoperitoneum.


Chilaiditi Syndrome

Peritonitis Spontaneous bacterial peritonitis Hemoperitoneum Pneumoperitoneum. Unable to process the form. Gastrointestinal tract Goodsall’s rule Chilaiditi syndrome intussusception: Gastroenterol Hepatol N Y.

Another indication of Chilaiditi sign is when a patient changes positions, the area of radiolucency will not shift as seen in free air [ 4 ]. Tus, bowel decompression documented by a follow-up radiograph can confirm both the diagnosis of the condition and the success of the therapy, by showing the disappearance of subdiaphragmatic air and repositioning of distended intestine back to the normal position beneath the liver.

Imaging studies showed unremarkable chest X-ray and abdominal ultrasound. In rare cases, symptoms do develop; these cases are referred to as Chilaiditi’s syndrome.

The patient presented with epigastric and right stndrome quadrant pain sharp in nature with radiation to the right shoulder. Otherwise, colopexy may be sufficient to prevent future recurrence of symptoms. Her cardiac enzymes and urinalysis were unremarkable.

Chilaiditi syndrome | Radiology Reference Article |

Radiographic features Treatment and prognosis History and etymology References Images: Therefore, it is important to draw attention to the importance of this anomaly and its appropriate diagnosis and treatment to ensure the most favorable patient outcomes [ 15 ]. The incidence of this syndrome ranges from 0. He then received conservative treatment with fasting, nasogastric tube decompression, and pain control, and the symptoms improved 2 days later.

Case 5 Case 5. Ballance’s sign Traube’s sign Castell’s sign Kehr’s sign hemorrhage: On the other hand, a misdiagnosis of bowel perforation might result in unnecessary surgical intervention.

Diagnosis is best achieved with CT imaging. When evaluating a symptomatic patient with small bowel obstruction, clinicians should first rule out the more serious condition of pneumoperitoneum.