[Incarcerated Chilaiditi disease. A rare indication for surgery]

Area of Science:

• Gastroenterology and Surgical Sciences
• Abdominal Imaging and Diagnostics

Background:

• Chilaiditi's syndrome, characterized by hepatodiaphragmatic interposition of abdominal viscera, is a rare condition.
• Incarcerated Chilaiditi's syndrome presents significant surgical risks, particularly in elderly patients with comorbidities.

Observation:

• A 77-year-old patient presented with ileus and gastric volvulus due to incarcerated Chilaiditi's syndrome, involving stomach, colon, and omentum.
• The patient's poor condition necessitated intensive preoperative care due to hyperemesis and abdominal pain.

Findings:

• Surgical intervention involved repositioning intestinal structures, resecting the diaphragmatic hernia, and reconstructing liver position.
• Colon resection was required due to adhesions and limited intra-abdominal space, highlighting surgical complexity.

Implications:

• The study suggests enhancing diagnostic protocols for incidental Chilaiditi's syndrome findings, even in asymptomatic patients.
• Advanced imaging like CT scans and endoscopy are recommended for early detection and to guide prophylactic surgical strategies.