Chilaiditi's syndrome and obesity

Hepatodiaphragmatic interposition (HDI) of the colon or small intestine (Chilaiditi's syndrome) is more prevalent in the elderly and in men. The reason for this is unclear. In obese individuals, fat deposition between the liver and colon widens this potential space, and this may be an important factor in the etiology of this condition. As men store more fat intra-abdominally than women, this may explain the increased prevalence in men. This study was performed to investigate the relationship between Chilaiditi's syndrome and obesity. A total of 850 abdominal CT examinations were assessed for the presence of HDI of the colon or small intestine, and 10 patients with Chilaiditi's syndrome were identified. The present Body Mass Index (BMI) and the highest BMI in the past was recorded for each patient. Eight of the 10 patients were male; five had a BMI greater than 28.5 and three had a BMI between 25 and 27.5 at some period in their lives. Obesity may be a causative factor in the etiology of Chilaiditi's syndrome, and the difference in fat deposition between men and women may explain its increased prevalence in men.