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Chilaiditi`s syndrome: correct diagnosis can save the patient from unnecessary and life threatening surgery.

Taha Abdelkader Ahmed Taha

Chilaiditi syndrome is the interposition of the colon between the liver and the right hemidiaphragm. The incidence of this syndrome ranges from 0.025% to 0.28% and seems to increase with age. The sex ratio is 4:1, male to female. In these patients, the colon is displaced and caught between the liver and the right hemidiaphragm. Generally patients are asymptomatic but non-specific symptoms such as abdominal pain, distension, nausea, vomiting and constipation can be presented. Confusions could be avoided with proper diagnosis of this rare syndromic presentation with more serious abnormalities such as perforated viscus, pneumoperitoneum and subphrenic abscess. Recognition of Chilaiditi syndrome is important because this rare entity can be misleading to the surgeons and mistaken for more serious abnormalities, which may lead to unnecessary surgical interventions. Diagnosis is best achieved with CT imaging. Identification of Chilaiditi syndrome is clinically significant as it can lead to many significant complications such as volvulus, perforation, and bowel obstruction. If the patient is symptomatic, treatment is usually conservative. If the patient does not respond to initial conservative management, and either the obstruction fails to resolve or there is evidence of bowel ischemia, then surgical intervention is indicated