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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Both demonstrate a loop of colon interpositioned between the liver and right hemidiaphragm. Chilaiditi syndrome caused by Fitz-Hugh-Curtis syndrome: Diagnosis of Chilaiditi syndrome is extremely important because this rare syndrome can lead to not only unnecessary but also hazardous surgery if not diagnosed.

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However, variations in normal anatomy can lead to the pathologic interposition of the colon. The incidence of this syndrome ranges from 0. In one case it was complicated by megacol on progressed to heart failure casing death. He had no surgeries in the past. Further Investigations revealed normal cardiac functions and gas under the right hemidiaphragm suggestive of pneumoperitoneum.

Her past surgical history included a laminectomy for her back pain. Case 10 Case Predisposing congenital abnormalities include absent suspensory or falciform ligaments, redundant colon, malpositions, dolichocolons, and paralysis of the right diaphragm [ 14 ]. Complications of Chilaiditi syndrome may include a volvulus of the cecum, splenic flexure, or transverse colon.


The condition occurs with greater frequency in individuals with chronic lung disease, scarring of the liver cirrhosisand the accumulation of fluid within the abdominal cavity ascites. This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and sindrpme in any medium, provided the original work is properly cited.

Chilaiditi’s syndrome masquerading as chest pain Goel A, Dewanda NK – J Sci Soc

In most cases, interposition of a portion of colon between the liver and diaphragm does not cause symptoms asymptomatic and is often an incidental finding in the elderly. Additional predisposing factors include abnormal elongation of the colon or abnormal looseness laxity of certain ligaments of the chilaidktis and liver.

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Patients with recurrent presentations or evidence of bowel ischemia may be offered surgical treatment. 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. Chest X-ray Figure 1a and 1b showed air under right hemidiaphragm but plain abdominal X-ray left lateral decubitus position did not show free intraperitoneal air. Kamiyoshihara presents a case where after a traffic accident, a 75 year old is believed to have developed a traumatic diaphragmatic hernia.

Pneumoperitoneum can have a variety of different causes. Chest X-ray showing obvious Chilaiditi’s sign, or presence of gas in the right colic angle between the liver and right hemidiaphragm. Case 14 Case Report of three cases. Diagnosis is best achieved with CT imaging.


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

Figure 1a and 1b: Chilaiditi syndrome is the interposition of the colon between the liver and the right hemidiaphragm.

An unusual cause of chest or abdominal pain.

The 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.

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.

Chilaiditi Syndrome

Involvement of the transverse colon carries a high frequency of gangrene; therefore, colonoscopic reduction is not suggested [ 4 ]. Symptom-producing interposition of the colon. Diseases of the digestive system primarily K20—K93— This entity was first described by Demetrius Chilaiditi in The Chilaiditi syndrome and associated volvulus of the transverse colon.

No intervention is required for an asymptomatic patient with Chilaiditi sign.

Support Radiopaedia and see fewer ads. With normal human anatomy, the suspensory ligaments of the liver, mesocolon, liver, chlaiditis the falciform ligament are situated in a manner that minimizes space surrounding the liver and prevents interposition of the colon. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide.