A 72-year-old male presented to the Emergency Department for evaluation of worsening
right upper quadrant (RUQ) abdominal pain. The patient had suffered from chronic RUQ
discomfort for the past several months; his pain became significantly worse, with
intermittent cramping, prompting the ED visit. In addition, the patient had new-onset
constipation over the past several weeks. His medical history was most notable for
bilateral diaphragmatic palsy of unclear etiology and ischemic heart disease. His
vital signs were stable and physical examination was only significant for RUQ tenderness
to deep palpation. Blood work, including liver function tests, was unremarkable. A
chest X-ray demonstrated small lung volumes and bilateral hemidiaphragmatic elevation.
The transverse colon was thought to be interposed between the right hemidiaphragm
and the liver (black arrow), consistent with Chilaiditi sign (Figure 1).
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References
- Image of the month. Chilaiditi sign or syndrome..Arch Surg Chic Ill 1960. 2008; 143: 93-94
- Chilaiditi syndrome.Gastroenterol Hepatol. 2012; 8: 276-278
- Chilaiditi's syndrome: report of three cases.JAMA. 1985; 254: 944-945
- Transverse colon volvulus and Chilaiditi syndrome: an exceptional association.Am Surg. 2011; 77: E244-E245
Article info
Publication history
Published online: March 18, 2020
Accepted:
March 11,
2020
Received:
December 23,
2019
Footnotes
Grants or industrial support: None.
Conflicts of interest: All authors have no conflict of interest. BKS and AB were directly involved in patient care. All authors participated in the preparation of the manuscript.
Identification
Copyright
© 2020 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
