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Acute abdominal pain secondary to chilaiditi syndrome.

Kang D, Pan AS, Lopez MA, Buicko JL, Lopez-Viego M - Case Rep Surg (2013)

Bottom Line: Diagnosis is best achieved with CT imaging.If the patient is symptomatic, treatment is usually conservative.Surgery is rarely indicated with indications including ischemia and failure of resolution with conservative management.

View Article: PubMed Central - PubMed

Affiliation: NOVA Southeastern University College of Osteopathic Medicine, Davie, FL, USA.

ABSTRACT
Chilaiditi syndrome is a rare condition occurring in 0.025% to 0.28% of the population. In these patients, the colon is displaced and caught between the liver and the right hemidiaphragm. Patients' symptoms can range from asymptomatic to acute intermittent bowel obstruction. 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. Surgery is rarely indicated with indications including ischemia and failure of resolution with conservative management.

No MeSH data available.


Related in: MedlinePlus

(a) Coronal CT view. (b) Axial CT view. Both demonstrate a loop of colon interpositioned between the liver and right hemidiaphragm.
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fig1: (a) Coronal CT view. (b) Axial CT view. Both demonstrate a loop of colon interpositioned between the liver and right hemidiaphragm.

Mentions: Basic laboratory studies revealed a mild hyponatremia (134 mmol/dL). A hepatic panel was within normal limits. Complete blood count demonstrated a normal wbc and platelet count accompanied by a mild anemia (Hb/Hct 11.8/35.4). Her cardiac enzymes and urinalysis were unremarkable. Imaging studies showed unremarkable chest X-ray and abdominal ultrasound. A HIDA scan with CCK showed a decreased gallbladder ejection fraction of 33% (normal: 35–75%). Further imaging by CT scan of the thorax, abdomen, and pelvis showed a loop of colon interpositioned between the liver and right hemidiaphragm, mimicking free air (Figure 1). There was mild bowel wall thickening involving the mid-transverse colon and descending colon, but there was no evidence of bowel obstruction. These findings suggested Chilaiditi's syndrome.


Acute abdominal pain secondary to chilaiditi syndrome.

Kang D, Pan AS, Lopez MA, Buicko JL, Lopez-Viego M - Case Rep Surg (2013)

(a) Coronal CT view. (b) Axial CT view. Both demonstrate a loop of colon interpositioned between the liver and right hemidiaphragm.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3713330&req=5

fig1: (a) Coronal CT view. (b) Axial CT view. Both demonstrate a loop of colon interpositioned between the liver and right hemidiaphragm.
Mentions: Basic laboratory studies revealed a mild hyponatremia (134 mmol/dL). A hepatic panel was within normal limits. Complete blood count demonstrated a normal wbc and platelet count accompanied by a mild anemia (Hb/Hct 11.8/35.4). Her cardiac enzymes and urinalysis were unremarkable. Imaging studies showed unremarkable chest X-ray and abdominal ultrasound. A HIDA scan with CCK showed a decreased gallbladder ejection fraction of 33% (normal: 35–75%). Further imaging by CT scan of the thorax, abdomen, and pelvis showed a loop of colon interpositioned between the liver and right hemidiaphragm, mimicking free air (Figure 1). There was mild bowel wall thickening involving the mid-transverse colon and descending colon, but there was no evidence of bowel obstruction. These findings suggested Chilaiditi's syndrome.

Bottom Line: Diagnosis is best achieved with CT imaging.If the patient is symptomatic, treatment is usually conservative.Surgery is rarely indicated with indications including ischemia and failure of resolution with conservative management.

View Article: PubMed Central - PubMed

Affiliation: NOVA Southeastern University College of Osteopathic Medicine, Davie, FL, USA.

ABSTRACT
Chilaiditi syndrome is a rare condition occurring in 0.025% to 0.28% of the population. In these patients, the colon is displaced and caught between the liver and the right hemidiaphragm. Patients' symptoms can range from asymptomatic to acute intermittent bowel obstruction. 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. Surgery is rarely indicated with indications including ischemia and failure of resolution with conservative management.

No MeSH data available.


Related in: MedlinePlus