Chilaiditi Syndrome

Definition

  • Chilaiditi Sign (see CXR-Chilaiditi Sign, [[CXR-Chilaiditi Sign]]): Interposition of Loop of Colon (Usually Transverse Colon) Between the Liver and Right Hemidiaphragm
    • Visible on CXR or KUB: present on 0.1% or abdominal or chest x-rays
      • Incidence can be as high as 1% in older adults
      • Has been reported in children
    • May be permanent or sporadic
    • First described by the Greek radiologist, Dimítrios Chilaiditi, in 1910 while he was working in Vienna

Predisposing/Etiologic Factors

  • Absence or Laxity of the Ligament Suspending the Transverse Colon or of the Falciform Ligament
  • Ascites (see Ascites, [[Ascites]])
  • Chronic Obstructive Lung Disease (COPD) (see Chronic Obstructive Pulmonary Disease, [[Chronic Obstructive Pulmonary Disease]])
  • Cirrhosis (see End-Stage Liver Disease, [[End-Stage Liver Disease]])
  • Dolichocolon: long and mobile colon
  • Relative Atrophy of the Medial Segment of the Left Lobe of the Liver: usually associated with anomalous gallbladder position (located anterior, rather than posterior, to liver)

Diagnosis

  • CXR

Clinical Manifestations of Chilaiditi Syndrome

Gastrointestinal Manifestations

  • Abdominal Pain (see Abdominal Pain, [[Abdominal Pain]])
  • Dyspnea (see Dyspnea, [[Dyspnea]]): has been reported in pediatric cases
  • Transverse Colonic Volvulus (see Colonic Volvulus, [[Colonic Volvulus]])

References

  • D Chilaiditi: Zur Frage der Hepatoptose und Ptose im allgemeinen im Anschluss an drei Fälle von temporärer, partieller Leberverlagerung. Fortschritte auf dem Gebiete der Röntgenstrahlen, 1910, 16: 173-208
  • Chilaiditi syndrome. Age Ageing 1977: 6 (1): 51–7. doi:10.1093/ageing/6.1.51 [MEDLINE]
  • Transverse colon volvulus and associated Chilaiditi’s syndrome: case report and literature review. Am. J. Gastroenterol 1996: 91 (12): 2613–6 [MEDLINE]
  • Chilaiditi’s syndrome: what should every surgeon know?. Am Surg 2005: 71 (3): 261–3 [MEDLINE]
  • Chilaiditi syndrome as a cause of respiratory distress. Eur J Pediatr 2006: 165 (6): 367–9. doi:10.1007/s00431-005-0077-9 [MEDLINE]
  • Severe Recurrent Abdominal Pain: An Anatomical Variant of Chilaiditi’s Syndrome. MedGenMed 2007: 9 (2): 67 [MEDLINE]