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Updated: Jun 25, 2026
05:51
Diaphragmatic Ultrasound in Adults: Image Acquisition and Interpretation
Published on: January 31, 2025
Chilaiditi's sign mimicking a traumatic diaphragmatic hernia
Mitsuhiro Kamiyoshihara1, Takashi Ibe, Izumi Takeyoshi
1Department of General Thoracic Surgery, Maebashi Red Cross Hospital, Maebashi, Gunma, Japan. micha2005jp@yahoo.co.jp
The Annals of Thoracic Surgery
|February 24, 2009
Summary
Chilaiditi's sign, a rare anomaly where the colon is between the liver and diaphragm, can mimic a traumatic diaphragmatic hernia. This case highlights the importance of accurate diagnosis in emergency imaging.
Area of Science:
- Gastroenterology
- Radiology
- Thoracic Surgery
Background:
- Traumatic diaphragmatic hernia is a critical surgical emergency often suspected after significant trauma.
- Imaging plays a crucial role in diagnosing diaphragmatic injuries, but rare anomalies can complicate interpretation.
Observation:
- A 75-year-old male presented with bruising post-trauma, showing right hemidiaphragm elevation on chest X-ray.
- CT scan revealed colonic interposition between the liver and diaphragm, anterior to the liver, initially suggesting diaphragmatic hernia.
Findings:
- Exploratory video-assisted thoracoscopic surgery confirmed no diaphragmatic injury.
- The imaging findings were attributed to Chilaiditi's sign, a rare congenital or acquired anomaly of colonic displacement.
Implications:
- Chilaiditi's sign can present as a diagnostic challenge, mimicking traumatic diaphragmatic hernia.
- Accurate radiological assessment and clinical correlation are vital to avoid unnecessary surgical interventions for rare anatomical variations.
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