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 Syndrome

Chilaiditi syndrome Chest X-ray showing obvious Chilaiditi’s sign, or presence of gas in the right colic angle between the liver and right hemidiaphragm.

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. Chilqiditi and sonographic detection of Chilaiditi’s sign in cirrhotic patients without ascites.

Chilaiditi syndrome can be a self-resolving or a chronic condition [ 4 ]. A patient is predisposed to Chilaiditi syndrome when there is deviation of the structures surrounding the liver. You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Identification of Chilaiditi syndrome is clinically significant as it can lead to many significant complications such as volvulus, perforation, and bowel obstruction. 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.


Her abdomen was soft but exhibited tenderness to palpation in the epigastrium as well as the right upper quadrant. Ligaments are tough, fibrous bands of tissue that primarily serve to connect or support structures within the body.

Identification of Chilaiditi syndrome is clinically significant as it can lead to many significant complications such as volvulus, perforation, and bowel obstruction.

Recognition of Chilaiditi syndrome is important because this rare entity can be misleading to syndrpme surgeons and mistaken for more serious abnormalities, which chilauditi lead to unnecessary surgical interventions.

All studies receiving U. Case 7 Case 7. In this case, the gallbladder position is often anomalous as well — it is often located anterior to the liver, rather than posterior. In rare cases, symptoms do develop; these cases are referred to as Chilaiditi’s syndrome.

Chilaiditi syndrome | QJM: An International Journal of Medicine | Oxford Academic

On the other hand, a misdiagnosis of bowel perforation might result in unnecessary surgical intervention. Erect chest x-ray showing air under right hemi-diaphragm.

Moreover, changing the position of a patient with Chilaiditi sign will not change the position of the radiolucency, unlike in a patient with free air. A year-old man presented to our emergency department because of progressive epigastric pain to right upper quadrant pain, nausea, and vomiting that had persisted for 2 days.

Upper Hematemesis Melena Lower Hematochezia. Patients with recurrent presentations or evidence of bowel ischemia may be offered surgical treatment.

CT can clearly demonstrate the presence of interposed colonic loops between the right hemidiaphragm and liver with no free intraperitoneal air. Email alerts New issue alert. Chilaiditi syndrome as a cause of respiratory distress. Severe recurrent abdominal pain: Initial management of Chilaiditi chilsiditi should include bed rest, intravenous fluid therapy, bowel decompression, enemas, and laxatives.


Administration of carbon dioxide as the insufflating agent for colonoscopy is appropriate for decreasing this risk. Dyspnea and large bowel obstruction: For Permissions, please email: 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.

Alone we are rare. Subscribe to Table of Contents Alerts. The content of the website and databases of the National Organization for Rare Disorders NORD is copyrighted and may not be reproduced, copied, downloaded or disseminated, chilziditi any way, for any commercial or public purpose, without prior written authorization and approval from NORD.

The patient presented with epigastric syndro,e right upper quadrant pain sharp in nature with radiation to the right shoulder. Chilaidiyi patient underwent exploratory video-assisted thoracoscopic surgery where it was discovered there had been no injury to the diaphragm or any other organs despite the strong clinical suspicion. The specific symptoms that occur depend upon the cause.

Cecopexy may be adequate to eliminate the possibility of recurrence in an uncomplicated cecal volvulus, unless gangrene or perforation necessitates surgical resection. Gastroenterol Hepatol N Y.