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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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.

The incidence of this syndrome ranges from 0. A Complete blood count demonstrated a normal study.

Chilaiditi Syndrome

Chilaiditi syndrome is extremely rare. About Blog Go ad-free. When no symptoms are present, this clinical finding is referred to as Chilaiditi’s sign. The finding of normal plicae circulares or haustral markings of the colon under the diaphragm can rule out these more serious entities. It is important to identify Chilaiditi sign in order to prevent complications from occurring during a percutaneous transhepatic procedure or liver biopsy, particularly in cirrhotic patients, who are predisposed to development of Chilaiditi sign.

A repeat radiograph following bowel decompression may show disappearance of the air below the diaphragm.

There was mild bowel wall thickening involving the mid-transverse colon and descending colon, but there was no evidence of bowel obstruction. Another indication of Chilaiditi sign is when a patient changes positions, the area of radiolucency will not shift as seen in free air [ 4 ]. If the patient is symptomatic, treatment is usually conservative. Differentials of Chilaiditi syndrome include bowel obstruction, volvulus, intussusception, ischemic bowel, appendicitis, and diverticulitis [ 4 ].


Local examination of respiratory, cardiac system revealed nothing significant. This anatomical variant is sometimes mistaken for the more serious condition of having air under the diaphragm pneumoperitoneum which is usually an indication of bowel perforationpossibly leading to surgical interventions.

Chilaiditi syndrome complicated by a closed-loop small bowel obstruction.

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 ]. But a proper workup sinfrome keeping in mind the possibility of Chilaiditi syndrome kept the patient out of the operating room for what would have proven to be an unnecessary procedure. In recent years, surgical intervention has been increasingly used in order to manage symptoms of chronic, intermittent abdominal pain.

No intervention is required for an asymptomatic patient with Chilaiditi sign. Dyspnea and large bowel obstruction: Pain distinguishes Chilaiditi syndrome from asymptomatic colonic interposition, which is termed as Chilaiditi sign. A hepatic panel was within normal limits. Chilaiditi syndrome is a sindrime condition when pain occurs due to transposition of a loop of large intestine usually transverse colon in between the diaphragm and the livervisible on plain abdominal X-ray or chest X-ray.

Acute Abdominal Pain Secondary to Chilaiditi Syndrome

The Chilaiditi syndrome and associated volvulus of the transverse colon [in Spanish] Rev Gastroenterol Peru. View large Download slide. Gastroenterol Hepatol N Y. Scleromalacia perforans in rheumatoid arthritis.

Diagnosis is best achieved with CT imaging. Retrieved from ” https: CT can clearly demonstrate the presence of interposed colonic loops between the right hemidiaphragm and liver with no free intraperitoneal air. Additional predisposing factors include abnormal elongation of the colon or abnormal looseness laxity of certain ligaments of the colon and liver. How to cite this URL: Indexed in Web of Science.


The presentation and specific sndrome that develop can be significantly different. This page vhilaiditis last edited on 20 Aprilat Together we are strong.

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

It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. However, variations in normal anatomy can lead to the pathologic interposition of the colon. For the diagnosis to be made by imaging, the right hemidiaphragm must be displaced superiorly to the liver by the intestines, pseudo-pneumo peritoneum caused by air in the bowels must be seen, and the superior aspect of the liver must be positioned below the level of the left hemidiaphragm.

Transverse sndrome volvulus and Chilaiditi syndrome: His family history was significant for hypertension. No history of similar attacks in the past. Chilaiditi’s syndrome can cause a variety of symptoms including abdominal pain, nausea, vomiting, and small bowel obstruction. Chilaiditi’s sign in a child chilxiditis nephrotic syndrome.

Syndromes affecting the gastrointestinal tract. After careful inspection of radiograph it was found to be gas filled small bowel between liver and diaphragm, which was later confirmed by ultrasound examination. Abdominal pain may be mild and come and go intermittent.

Symptom-producing interposition of the colon. The pain was sharp in nature and radiated to the right shoulder. Imaging studies showed unremarkable chest X-ray and abdominal ultrasound.