Keywords
Chilaiditi syndrome
Pulmonary Disease
Chronic Obstructive
Mass Chest X-Ray
Pulmonary Disease
Chronic Obstructive
Mass Chest X-Ray
How to Cite
Estévez-Ramírez, G. M., Jiménez-Andrade, V. C., & Fajardo-Rivero, J. E. (2018). Chilaiditi sign as an incidental finding in a patient with respiratory disease: a case report. Médicas UIS, 31(3), 57–61. https://doi.org/10.18273/revmed.v31n3-2018006
Abstract
The Chilaiditi sign is a rare radiographic finding, which consists in the interposition of an intestinal handle between the liver and the diaphragm. There is no clear etiology established, however, several hypotheses have been proposed to explain its presence, including
the hyper-laxity of the liver suspensory ligaments, an increase on the intra-abdominal pressure and colonic redundancy. When this finding is associated with gastrointestinal or respiratory symptoms is called “Chilaiditi syndrome”, and its treatment is mainly symptomatic;
in exceptional cases a surgical approach is required. The Chilaiditi sign is usually an incidental finding, and a connection with chronic respiratory disease has been seen, and it could affect this pathology’s clinical course, being this a motivation to deepen in an integral study. We present a case of an elder patient, being followed due to chronic obstructive pulmonary disease, whose chest X-ray shows interposition of an intestinal handle between the right diaphragmatic dome and the liver. MÉD.UIS. 2018;31(3):57-61.
References
1. Aguilar-García CR, García-Acosta J. Signo y síndrome de Chilaiditi. Reporte de caso. Rev Med Inst Mex Seguro Soc. 2017;55(1):114-7.
2. Chen YY, Chang H, Lee SC, Huang TW. Chilaiditi syndrome presenting as chest pain in an adult patient: a case report. J Med Case Rep. 2014;8(1).
3. Aguilar-García CR, García-Acosta J. Signo y síndrome de Chilaiditi. Reporte de caso. Rev Med Inst Mex Seguro Soc. 2017;55(1):114-7.
4. Hountis P, Chounti M. Chilaiditi’s sign or syndrome? Diagnostic question in two patients with concurrent cardiovascular diseases. Monaldi Arch Chest Dis. 2017;87(2).
5. Tangri N, Singhal S, Sharma P, Mehta D, Bansal S, Bhushan N, et
al. Coexistence of pneumothorax and chilaiditi sign: A case report.
Asian Pac J Trop Biomed. 2014;4(1):75–7.
6. Flores N, Ingar C, Sánchez J, Fernández J, Lazarte C, Málaga J, et al.
Reporte de casos. Síndrome de Chilaiditi complicado con Vólvulo
de Colon transverso. Rev Gastroenterol Perú. 2005;25(3):279–84.
7. Hsu HL, Liu KL. Hepatodiaphragmatic interposition of the colon.
Cmaj. 2011;183(2):92117.
8. Weng WH, Liu DR, Feng CC, Que RS. Colonic interposition
between the liver and left diaphragm - management of chilaiditi
syndrome: A case report and literature review. Oncol Lett.
2014;7(5):1657–60.
9. Bredolo F, Esposito A, Casiraghi E, Cornalba G, Biondetti P.
Intestinal interposition: the prevalence and clinical relevance
of non-hepatodiaphragmatic conditions (non-Chilaiditi forms)
documented by CT and review of the literature. Radiol Med.
2011;116(4):607–19.
10. Murphy JM, Maibaum A, Alexander G, Dixon AK. Chilaiditi’s
Syndrome and Obesity. Clinic Anat. 2000;13(3):181–4.
11. Zhang R, Tan J, Zhang G, Wang R. Chilaiditi syndrome with an
unusual radiographic image: A crescent-shaped liver. Dig Liver.
2017;49(4):452.
12. Gil Díaz MJ, Murillo Gómez M, Jiménez González P. Signo y
síndrome de Chilaiditi: Entidades a tener en cuenta. Semergen.
2011;37(5):267–9.
13. Nair N, Takieddine Z, Tariq H. Colonic interposition between the
liver and diaphragm: “the chilaiditi sign.” Can J Gastroenterol
Hepatol. 2016;2016:4–5.
14. Moaven O, Hodin RA. Chilaiditi syndrome: A rare entity
with important differential diagnoses. Gastroenterol Hepatol.
2012;8(4):276–8.
15. Longo WE. Image of the Month-Quiz Case. Arch Surg.
2008;143(1):93. doi:10.1001/archsurg.2007.12-a
16. Alva S, Shetty-Alva N, Longo WE. Image of the month. Chilaiditi
sign or syndrome. Arch Surg. 2008;143(1):94. doi:10.1001/
archsurg.2007.12-b
17. Garg K, Mohapatra PR, Aggarwal D, Gupta R, Janmeja AK.
Interstitial lung disease with chilaiditi syndrome. J Clin
Diagnostic Res. 2016;10(12):TD04–5.
18. Uygungul E, Uygungul D, Ayrik C, Narci H, Bozkurt S, Köse A.
Chilaiditi sign: Why are clinical findings more important in ED?.
Am J Emerg Med. 2015; 33(5):733.e1–733.e2.
19. Lopez C, Lopez E, Iannuzzelli C, Sanchiz B. Signo de Chilaiditi
como hallazgo casual. [En internet] Revista Atalaya Médica.
2015; 8. Disponible en: http://atalayamedica.comteruel.org/
index.php/revista/article/view/110/116.
20. Kumar S, Singh GV, Singh R, Singh DP. Rare association B/W
respiratory distress and chilaiditi syndrome. Indian J Allergy
Asthma Immunol 2012;26(8):9–10.
21. Westerwel PE. Hemmer JM. Displaced Colon: Chilaiditi´s sign.
Intern Med J. 2004;(34):440.
22. Tuncer M, Sahin C, Yazici O, Kafkasli A, Sarica K. A rare cause of
renal colic pain: Chilaiditi syndrome. Arch Ital di Urol Androl.
2014;86(3):229–30+229a.
23. Okiro JO. Chilaiditi syndrome mimicking congestive heart
failure. BMJ Case Rep. Published Online First: [15 Feb 2018].
doi:10.1136/bcr-2017- 220811.
24. Kang D, Pan AS, Lopez M a, Buicko JL, Lopez-Viego M. Acute
abdominal pain secondary to chilaiditi syndrome. Case Rep Surg.
2013;2013:756590.
25. Indiran V, Kannan K, Ramachandra Prasad T, Maduraimuthu P.
Chilaiditi sign. Abdom Radiol. 2017;42(8):2188–9.
26. Boddy ST, McDonnell D, Mayo D, Nichols P. Chilaiditi’s
syndrome as a cause for shock. BMJ Case Rep. 2015. doi:10.1136/
bcr-2014-207743
27. Melester T, Burt ME. Chilaiditi’s Syndrome: Report of three
cases. JAMA. 1985;254(7):944-945.
28. Cetin D, Unübol M, Soyder A, Güney E, Coşkun A, Ozbaş
S, et al. Coexistence of Multiple Endocrine Neoplasia Type
2B and Chilaiditi Sign: A Case Report. Case Rep Endocrinol.
2012;2012:360328.
29. Antonacci N, Di Saverio S, Biscardi A, Giorgini E, Villani S,
Tugnoli G. Dyspnea and large bowel obstruction: A misleading
Chilaiditi syndrome. Am J Surg. 2011;202(5):e45–7.
2. Chen YY, Chang H, Lee SC, Huang TW. Chilaiditi syndrome presenting as chest pain in an adult patient: a case report. J Med Case Rep. 2014;8(1).
3. Aguilar-García CR, García-Acosta J. Signo y síndrome de Chilaiditi. Reporte de caso. Rev Med Inst Mex Seguro Soc. 2017;55(1):114-7.
4. Hountis P, Chounti M. Chilaiditi’s sign or syndrome? Diagnostic question in two patients with concurrent cardiovascular diseases. Monaldi Arch Chest Dis. 2017;87(2).
5. Tangri N, Singhal S, Sharma P, Mehta D, Bansal S, Bhushan N, et
al. Coexistence of pneumothorax and chilaiditi sign: A case report.
Asian Pac J Trop Biomed. 2014;4(1):75–7.
6. Flores N, Ingar C, Sánchez J, Fernández J, Lazarte C, Málaga J, et al.
Reporte de casos. Síndrome de Chilaiditi complicado con Vólvulo
de Colon transverso. Rev Gastroenterol Perú. 2005;25(3):279–84.
7. Hsu HL, Liu KL. Hepatodiaphragmatic interposition of the colon.
Cmaj. 2011;183(2):92117.
8. Weng WH, Liu DR, Feng CC, Que RS. Colonic interposition
between the liver and left diaphragm - management of chilaiditi
syndrome: A case report and literature review. Oncol Lett.
2014;7(5):1657–60.
9. Bredolo F, Esposito A, Casiraghi E, Cornalba G, Biondetti P.
Intestinal interposition: the prevalence and clinical relevance
of non-hepatodiaphragmatic conditions (non-Chilaiditi forms)
documented by CT and review of the literature. Radiol Med.
2011;116(4):607–19.
10. Murphy JM, Maibaum A, Alexander G, Dixon AK. Chilaiditi’s
Syndrome and Obesity. Clinic Anat. 2000;13(3):181–4.
11. Zhang R, Tan J, Zhang G, Wang R. Chilaiditi syndrome with an
unusual radiographic image: A crescent-shaped liver. Dig Liver.
2017;49(4):452.
12. Gil Díaz MJ, Murillo Gómez M, Jiménez González P. Signo y
síndrome de Chilaiditi: Entidades a tener en cuenta. Semergen.
2011;37(5):267–9.
13. Nair N, Takieddine Z, Tariq H. Colonic interposition between the
liver and diaphragm: “the chilaiditi sign.” Can J Gastroenterol
Hepatol. 2016;2016:4–5.
14. Moaven O, Hodin RA. Chilaiditi syndrome: A rare entity
with important differential diagnoses. Gastroenterol Hepatol.
2012;8(4):276–8.
15. Longo WE. Image of the Month-Quiz Case. Arch Surg.
2008;143(1):93. doi:10.1001/archsurg.2007.12-a
16. Alva S, Shetty-Alva N, Longo WE. Image of the month. Chilaiditi
sign or syndrome. Arch Surg. 2008;143(1):94. doi:10.1001/
archsurg.2007.12-b
17. Garg K, Mohapatra PR, Aggarwal D, Gupta R, Janmeja AK.
Interstitial lung disease with chilaiditi syndrome. J Clin
Diagnostic Res. 2016;10(12):TD04–5.
18. Uygungul E, Uygungul D, Ayrik C, Narci H, Bozkurt S, Köse A.
Chilaiditi sign: Why are clinical findings more important in ED?.
Am J Emerg Med. 2015; 33(5):733.e1–733.e2.
19. Lopez C, Lopez E, Iannuzzelli C, Sanchiz B. Signo de Chilaiditi
como hallazgo casual. [En internet] Revista Atalaya Médica.
2015; 8. Disponible en: http://atalayamedica.comteruel.org/
index.php/revista/article/view/110/116.
20. Kumar S, Singh GV, Singh R, Singh DP. Rare association B/W
respiratory distress and chilaiditi syndrome. Indian J Allergy
Asthma Immunol 2012;26(8):9–10.
21. Westerwel PE. Hemmer JM. Displaced Colon: Chilaiditi´s sign.
Intern Med J. 2004;(34):440.
22. Tuncer M, Sahin C, Yazici O, Kafkasli A, Sarica K. A rare cause of
renal colic pain: Chilaiditi syndrome. Arch Ital di Urol Androl.
2014;86(3):229–30+229a.
23. Okiro JO. Chilaiditi syndrome mimicking congestive heart
failure. BMJ Case Rep. Published Online First: [15 Feb 2018].
doi:10.1136/bcr-2017- 220811.
24. Kang D, Pan AS, Lopez M a, Buicko JL, Lopez-Viego M. Acute
abdominal pain secondary to chilaiditi syndrome. Case Rep Surg.
2013;2013:756590.
25. Indiran V, Kannan K, Ramachandra Prasad T, Maduraimuthu P.
Chilaiditi sign. Abdom Radiol. 2017;42(8):2188–9.
26. Boddy ST, McDonnell D, Mayo D, Nichols P. Chilaiditi’s
syndrome as a cause for shock. BMJ Case Rep. 2015. doi:10.1136/
bcr-2014-207743
27. Melester T, Burt ME. Chilaiditi’s Syndrome: Report of three
cases. JAMA. 1985;254(7):944-945.
28. Cetin D, Unübol M, Soyder A, Güney E, Coşkun A, Ozbaş
S, et al. Coexistence of Multiple Endocrine Neoplasia Type
2B and Chilaiditi Sign: A Case Report. Case Rep Endocrinol.
2012;2012:360328.
29. Antonacci N, Di Saverio S, Biscardi A, Giorgini E, Villani S,
Tugnoli G. Dyspnea and large bowel obstruction: A misleading
Chilaiditi syndrome. Am J Surg. 2011;202(5):e45–7.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2018 Revista Médicas UIS
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