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Differentiating Chilaiditi's Syndrome with hollow viscus perforation: A case report
Imam Sofii1, Zakariya Aji Parminto2, Sumadi Lukman Anwar3
1Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
International Journal of Surgery Case Reports
|January 2, 2021
Summary
Chilaiditi's syndrome, a rare cause of abdominal discomfort, involves bowel interposition between the diaphragm and liver. Recognizing its unique imaging findings is crucial to avoid misdiagnosis and unnecessary surgery.
Area of Science:
- Gastroenterology
- Radiology
- Abdominal Surgery
Background:
- Chilaiditi's syndrome is a rare condition (0.25%-0.28% of abdominal imaging).
- Accurate diagnosis is vital to prevent unnecessary surgical interventions for acute abdominal emergencies.
Observation:
- A 25-year-old female presented with abdominal discomfort and mild shortness of breath.
- Abdominal X-ray revealed bowel loop in the right subphrenic space.
- CT scan confirmed colonic interposition between the diaphragm and liver, indicating pseudo-pneumoperitoneum.
Findings:
- Chilaiditi sign is radiolucency caused by bowel between diaphragm and liver.
- Symptoms include pain, anorexia, diarrhea, nausea, vomiting, bloating, and constipation.
- Pseudopneumoperitoneum on X-ray can mimic bowel perforation.
Implications:
- Distinguishing Chilaiditi's syndrome from surgical emergencies like diaphragmatic hernia or bowel perforation is critical.
- Thorough physical examination, imaging, and timely follow-up are essential.
- Early recognition prevents unnecessary exploratory laparotomies and patient harm.
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