Distended bowel, usually hepatic flexure of the colon, interposed between the liver and the diaphragm:
The Chilaiditi Sign or Hepatodiaphragmatic Interposition of the Intestine.
Chilaiditi’s Syndrome is important because it can simulate pneumoperitoneum ( so also called pseudo-pneumo-peritoneum ) .
A rare disorder where a part of the colon, or sometimes intestine, is abnormally positioned between the liver and the diaphragm. The defect may occur in people who have chronic lung disease or abdominal ascites but may also occur in healthy individuals without causing symptoms.
The list of signs and symptoms mentioned in various sources for Chilaiditi syndrome includes the 8 symptoms listed below:
Asymptomatic , Abdominal pain , Vomiting , Anorexia , Constipation , Flatulence , Air swallowing and Feeling of pressure in upper abdomen when upright.
Features that suggest a Chilaiditisyndrome (termed the Chilaiditi sign) include:
gas between liver and diaphragm
rugal folds within the gas suggesting that it is within bowel and not free.
Named after Dr Demetrius Chiladaiti : Greek radiologist who described the radiographic findings in 1910 .
1. Lekkas CN, Lentino W. Symptom producing interposition of the colon: clinical syndrome in mentally deficient adults. JAMA 1978;240:747-50.
2. Vessal K, Borhanmanesh F. Hepatodiaphragmatic interposition of the intestine (Chilaiditi's syndrome). Clin Radiol1976;27:113-6.
3. Chilaiditi D. Zur Frage der Hepatoptose und Ptose im allgemeinen im Anschluss an drei Falle von temporarer, partieller Leberverlagerung. Fortschr Geb Rontgenstr Nuklearmed Erganzungsband1910; 16:173 -208
4. Robert D. Glatter, MD,Severe Recurrent Abdominal Pain: An Anatomical Variant of Chilaiditi's Syndrome, MedGenMed. 2007; 9(2): 67. Published online 2007 June 27.
5. D. F. Altomare,Chilaiditi's syndrome. Successful surgical correction by colopexy. Techniques in Coloproctology Volume 5, Number 3, 173-175, DOI: 10.1007/s101510100022
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