Chilaiditi syndrome is the anterior interposition of the colon to the liver reaching the under-surface of the right hemidiaphragm with associated upper abdominal. Chilaiditi syndrome is a rare condition when pain occurs due to transposition of a loop of large intestine (usually transverse colon) in between the diaphragm. Chilaiditi syndrome is the interposition of the colon between the liver and the right hemidiaphragm. The incidence of this syndrome ranges from % to %.

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Related articles Chest pain Chilaiditi’s syndrome small bowel. Diseases of the digestive system primarily K20—K93— Image of the month. The results of a hepatic panel were within the normal limits. Normally this causes no symptoms, and this is called Chilaiditi’ssign [ 1 ].

Subscribe to Table of Contents Alerts. No intervention is required for an asymptomatic patient with Chilaiditi sign.

In these chialiditis, the colon is displaced and caught between the liver and the right hemidiaphragm. No signs of rebound tenderness, guarding, or ascites were observed. Differentials of Chilaiditi syndrome include bowel obstruction, volvulus, intussusception, ischemic bowel, appendicitis, and diverticulitis [ 4 ].

He did not have shortness of breath, attacks of syncope, change in appetite, emesis, dysphagia, early satiety, fever, chills, night sweats, melena, hematochezia, or any changes in his bowel habits. Am J Gastroenterol ; The sign can be permanently present, or sporadically. However, if Chilaiditi snidrome develops with severe complications, including mechanical bowel obstruction, mesentery ischemia, perforation, and peritonitis, emergent surgery must be considered.


We present a rare case of a chilaiiditis female who presented with epigastric and right upper quadrant pain with radiation to the right shoulder. A Complete blood count demonstrated a normal study.

However, variations in normal anatomy can lead to the pathologic interposition of the colon. Diagnosis is best achieved with CT imaging. Usually it is an asymptomatic and incidental radiographic finding, but may present with a variety of symptoms. View large Download slide.

The content of the website and databases of the National Organization for Rare Disorders NORD is copyrighted and may not be reproduced, copied, downloaded or disseminated, in any way, for any commercial or public purpose, without prior written authorization and approval from NORD. However, as mentioned above, these intestinal disorders can also occur within the interposed colon in rare instances.

Case Reports in Surgery

The diaphragm is the muscle that separates the chest cavity from the abdomen. With normal human anatomy, the suspensory ligaments of the liver, mesocolon, liver, and the falciform ligament are situated in a manner that minimizes space surrounding the liver and prevents interposition of the colon.

Her past surgical history included a laminectomy for her back pain. Clin Exp Nephrol ; Upper Hematemesis Melena Lower Hematochezia. If repeat imaging shows failure of resolution or if ischemia is suspected, surgical treatment is indicated.

Chilaiditi syndrome is the interposition of the colon between the liver and the right hemidiaphragm. Related articles in PubMed Chilaiditi syndrome. In addition, Chilaiditi syndrome has been linked with pulmonary and gastrointestinal malignancies [ 4 ]. On the other hand, a misdiagnosis of bowel perforation might result in unnecessary surgical intervention.


The patient was managed conservatively chilaiditiw IV fluid hydration and pain management.

Chilaiditi’s Syndrome – NORD (National Organization for Rare Disorders)

Prevalence and sonographic detection of Chilaiditi’s sign in cirrhotic patients without ascites. If the patient is symptomatic, treatment is usually conservative. The cause of Chilaiditi’s syndrome is not fully understood. Viscerohepatodiaphragmatic interposition Chilaiditi’s syndrome in a child. Abdominal pain, constipation, vomiting, respiratory distress, anorexia, volvulus, and chiilaiditis are possible presentations of this syndrome [ 3 ].

Chilaiditi’s syndrome masquerading as chest pain Goel A, Dewanda NK – J Sci Soc

Gastrointestinal tract Goodsall’s rule Chilaiditi syndrome intussusception: After careful inspection of radiograph it was found to be gas filled small bowel between liver and diaphragm, which was later confirmed by ultrasound examination.

There were no signs of rebound tenderness, guarding, or ascites. J Assoc Physicians India ; Goodsall’s rule Chilaiditi syndrome intussusception: Symptom-producing interposition of the colon.

Over a century ago, the radiologist Demetrius Chilaiditi reported a small case sindgome of 3 patients with the incidental radiologic finding of colonic interposition between the liver and diaphragm.

Chilaiditi syndrome should be considered as a rare cause of intestinal obstruction of either the large or small bowel, as reported by Mateo de Acosta Andino and associates.

Goel A, Dewanda NK. Normally this causes no symptoms, and this is called Chilaiditi’s sign.