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Internal hernia of the transverse colon-Chilaiditi syndrome in a child

John J White1, Eva P Chavez, John Souza

  • 1Macon, Georgia, USA.

Journal of Pediatric Surgery
|May 3, 2002
PubMed

Insights

Chilaiditi Syndrome, a rare condition, occurred in an 11-year-old girl due to a redundant loop of transverse colon herniating behind the liver. Surgical colectomy was necessary due to severe symptoms and obstruction unresponsive to non-surgical treatments.

Area of Science:

  • Gastroenterology
  • Pediatric Surgery
  • Abdominal Imaging

Background:

  • Chilaiditi syndrome is a rare radiological finding characterized by the abnormal position of the colon in the subdiaphragmatic space.
  • It can be asymptomatic or present with symptoms mimicking bowel obstruction, appendicitis, or cholecystitis.

Observation:

  • An 11-year-old girl presented with chronic constipation, partial bowel obstruction, and severe right upper quadrant pain.
  • Imaging revealed a redundant loop of transverse colon herniated to a suprahepatic, subdiaphragmatic position, consistent with Chilaiditi Syndrome.

Findings:

  • The patient's symptoms were refractory to nonoperative management, indicating a need for surgical intervention.
  • A transverse colectomy was performed to address the symptomatic herniation and relieve the obstruction.

Implications:

  • This case highlights the importance of considering Chilaiditi Syndrome in pediatric patients with recurrent abdominal pain and signs of obstruction.
  • Surgical management, such as colectomy, may be required for symptomatic cases unresponsive to conservative treatment.
  • Early diagnosis and appropriate intervention can prevent complications associated with bowel obstruction in pediatric Chilaiditi Syndrome.

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