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 when pain occurs due to transposition of a loop of large intestine (usually transverse colon) in between the diaphragm. Chilaiditi syndrome is the interposition of the colon between the liver and the right hemidiaphragm. The incidence of this syndrome ranges from % to %.

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All studies receiving U. Colonic gas in this position may be misinterpreted as true pneumoperitoneum resulting in further imaging, investigation and treatment that is not required.

A year-old Caucasian sndrome presented to the emergency department with a hour history of nausea and worsening epigastric and right upper quadrant pain. Normally this causes no symptoms, and this is called Chilaiditi’s sign.

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For Permissions, please email: He did not have shortness of breath, attacks of syncope, change in appetite, emesis, dysphagia, early satiety, fever, chills, night sweats, melena, hematochezia, or any changes in his bowel habits. A hepatic panel was within normal limits.

Asymptomatic patients with Chilaiditi syndrome do not require specific treatment. Recognition of Chilaiditi syndrome is important because this rare entity can be misleading to the surgeons and mistaken for more serious abnormalities, which may lead to unnecessary surgical interventions.


Combined physical examinations and detailed imaging survey could be useful in making the correct diagnosis and avoiding unnecessary operation.

Loading Stack – 0 images remaining. Posteroanterior chest radiography revealed the presence of air below the right side of the diaphragm Figure 1a. A repeat radiograph following bowel decompression may show disappearance of the air below the diaphragm. J Sci Soc ; Synonyms include interpositio hepatodiaphragmatica, subphrenic displacement of the colon, subphrenic interposition syndrome and pseudopneumoperitoneum. A rare entity with important differential diagnoses. 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.

Dance’s sign Lockwood’s sign appendicitis: He was discharged uneventfully after medical therapy and remained symptom-free during 6 months of follow-up. The patient was successfully managed conservatively. A diagnosis of Chilaiditi’s syndrome is made based upon imaging radiographic confirmation of the abnormal positioning of the colon and the occurrence of associated symptoms. Administration of carbon dioxide as the insufflating agent for colonoscopy is appropriate for decreasing this risk.

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During the course eindrome her hospital stay, her abdominal pain resolved without surgical intervention. Her abdomen was soft but exhibited tenderness to palpation in the epigastrium as well as the right upper quadrant. Kamiyoshihara presents a case where after a traffic accident, a 75 year old is believed to have developed a traumatic diaphragmatic hernia. In recent years, surgical intervention has been increasingly used in order to manage symptoms of chronic, intermittent abdominal pain [ 6 ].


Normally this causes no symptoms, and this is called Chilaiditi’ssign [ 1 ].

Chilaiditi Syndrome

With regard to treatment of Chilaiditi syndrome, conservative management bed rest, intravenous fluids, nasogastric decompression, enemas, cathartics, high fiber diet, and stool softeners should be attempted first [ 1 ]. Viscerohepatodiaphragmatic interposition Chilaiditi’s syndrome in a child. sindrme

Case Reports in Surgery. Clin Exp Nephrol ; Chilaiditi’s syndrome masquerading as chest pain. He is a non-smoker, non-alcoholic and does not use any abusive drugs. Colonic interposition is usually an asymptomatic radiologic sign.

Articles containing German-language text Chiaiditis medical condition. 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.

Acute Abdominal Pain Secondary to Chilaiditi Syndrome

An interposed segment of bowel can also make it very diffcult to perform a colonoscopy. These symptoms can occur together in a wide variety of different combinations. How to cite this URL: