Chilaiditi Syndrome.

A 46-year-old man presented with a 2-day history of abdominal pain, nausea and vomiting. The abdomen was diffusely tender, and the bowel sounds were sluggish. Chest/abdominal radiographs (Picture 1, 2) and abdominal/pelvic computed tomography (CT) were performed (Picture 3). Chilaiditi syndrome is the interposition of the right colon between the liver and right hemi-diaphragm; the bowels containing air can be seen interposed between the liver and diaphragm on X-ray, helping to distinguish it from pneumoperitoneum. The presence of haustra in the hepato-diaphragmatic space aids in the distinction between intraluminal gas and free air. Abdominal/pelvic CT showing the bowel between the liver and diaphragm confirms the diagnosis. Chilaiditi syndrome was first described in 1910 by Chilaiditi, a Greek radiologist (1). The incidence of this syndrome in the general population ranges from 0.025% to 0.28% (2). Unless the presence of volvulus is suspected, patients with Chilaiditi syndrome often respond to conservative treatments, such as nasogastric decompression.

Picture 1.

Picture 2.

Picture 3.

The authors state that they have no Conflict of Interest (COI).