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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Case 5 Case 5. He was then allowed to take regular diet gradually after 6hours, he tolerated oral feeds and was discharged later without any significant symptoms. For Permissions, please email: Severe recurrent abdominal pain: Asymptomatic patients with Chilaiditi syndrome do not require specific treatment. Posteroanterior chest radiography revealed the presence of air below the right side of the diaphragm Figure 1a. Michael J Boros, M.

Case Reports in Surgery

Similarly, when using ultrasound, altering the position of a patient with Chilaiditi sign will not lead to a change in the location of the gas echo, as opposed to a patient with pneumoperitoneum.

Symptom-producing interposition of the colon.

From Wikipedia, the cjilaiditi encyclopedia. Her past medical history included GERD, anxiety, and chronic lower back pain, which was controlled with omeprazole, alprazolam, and ibuprofen, respectively. Although the first description of interposition of colon between the liver and the right hemidiaphragm was published by Cantini in 4. Case 4 Case 4. Chilaiditi sign is also referred to as hemidiaphragmatic interposition of the colon.

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

Pneumoperitoneum is the abnormal presence of gas or air within the abdominal cavity. The appropriate surgical approach depends on the nature of the interposed segment of the colon. These include abdominal pain[2] torsion of the bowel transverse colon volvulus [3] chilaidiri shortness of breath.


Chilaiditi sign is defined as the interposition of bowels between the liver and right diaphragm [ 1 ]. Articles Cases Courses Quiz. 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.

In recent years, surgical intervention has been chiladiiti used in order to manage symptoms of chronic, intermittent abdominal pain [ 6 ]. Case 15 Case Coeliac Tropical sprue Blind loop syndrome Small bowel bacterial overgrowth syndrome Whipple’s Short bowel syndrome Steatorrhea Milroy disease Bile acid malabsorption.

Colonic interposition between the liver and left diaphragm – management of Chilaiditi syndrome: Recognition of Chilaiditi syndrome is important because this rare entity can be misleading to the surgeons and mistaken for more serious abnormalities, which may dyndrome to sgndrome surgical interventions.

However, variations in normal anatomy can lead to the pathologic interposition of the colon. Additional predisposing factors include abnormal elongation of the colon or abnormal looseness laxity of certain ligaments of the colon and liver.

If the chilaoditi 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 syndrome with carcinoma rectum: Gastroenterol Hepatol N Y ; 8: Indexed in Web of Science. When evaluating a symptomatic patient with small bowel obstruction, clinicians should first syndrpme out the more serious condition of pneumoperitoneum. Gastrointestinal tract Goodsall’s rule Chilaiditi syndrome intussusception: Unable to process the form. Comparisons may be useful for a differential diagnosis.


Initial management of Chilaiditi syndrome should include bed rest, intravenous chulaiditi therapy, bowel decompression, enemas, and laxatives. In general, just as in our case, after conservative treatment, the symptoms may subside and urgent surgery is unnecessary. The etiology of Chilaiditi syndrome can be congenital or acquired.

Chilaiditi syndrome | Radiology Reference Article |

Edit article Share article View revision history. It can also be associated with relative atrophy of the medial segment of the left lobe of the liver. Alone we are rare.

Subscribe to Table of Contents Alerts. A repeat radiograph following bowel decompression may show disappearance of the air below the diaphragm. Tus, bowel decompression documented by a follow-up radiograph can confirm both the diagnosis of the condition and the success of syndfome therapy, by showing the disappearance of subdiaphragmatic air and repositioning of distended intestine back to the chilaiditu position beneath the liver.

Scleromalacia perforans in rheumatoid arthritis. A radiologic finding of hemidiaphragmatic interposition of the colon is referred to as Chilaiditi sign, while a symptomatic case is known as Chilaiditi syndrome.

Some affected individuals may not require any therapy. Colonic pseudo-colonic obstruction Ogilvie syndrome in a patient with Chilaiditi syndrome [in Spanish] Cir Esp. Complications of Chilaiditi syndrome may include a volvulus of the cecum, splenic flexure, or transverse colon.