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Chilaiditi's syndrome in an infant: bowel loops mimicking mass lesions on sonography
D London1, M Sestopal-Epelman, O Lebovici
1Division of Ultrasonography, Department of Radiology, Barzilai Medical Center, 78306, Ashkelon, Israel.
Insights
Chilaiditi's syndrome in infants can cause abdominal pain and an enlarged liver. Imaging may initially suggest a mass, but chest X-rays can reveal the correct diagnosis of bowel loops under the liver.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
Background:
- Chilaiditi's syndrome is a rare condition where the colon or small intestine is found between the liver and diaphragm.
- It can be asymptomatic or present with diverse abdominal symptoms.
Observation:
- A 6-month-old boy presented with tender hepatomegaly and abdominal pain.
- Sonography revealed interposed bowel loops, mimicking a hepatic or retroperitoneal mass.
Findings:
- The interposed bowel loops on ultrasound can be mistaken for a tumor.
- Erect chest or abdominal X-rays are crucial for accurate diagnosis.
Implications:
- Early recognition of Chilaiditi's syndrome is important to avoid unnecessary investigations or misdiagnosis.
- Radiological findings, particularly on plain films, are key to differentiating this condition from serious intra-abdominal pathologies.
Abstract:
We report the case of a 6-month-old boy with Chilaiditi's syndrome presenting with tender hepatomegaly and abdominal pain. On sonography the interposed bowel loops mimicked a posterior hepatic or retroperitoneal mass. Although the majority of these cases may be radiological curiosities, patients can present with a variety of abdominal signs and symptoms. The correct diagnosis will be suggested on chest or erect abdominal films.