Last update:
22-Mar-2022

Chilaiditi's sign is characterized by the asymptomatic incidental radiographic finding of an intestinal loop interposed between the liver and the diaphragm; the Chilaiditi syndrome refers to the sign and the associated abdominal or lower chest symptoms. An elderly male with comorbidities was admitted to hospital with a suspected perforating acute abdomen, because computed tomography (CT) showed redundant sigmoid, discrete pneumoperitoneum, distension of intestinal loops and hydroaeric levels. He was lethargic and with a gastrostomy. In the previous 24 hours he had presented nausea, vomiting, diarrhea, diffuse abdominal pain and reduced urine output. The chest X-ray showed air under the diaphragm and marked dilation of colonic loops causing diaphragmatic elevation, whereas abdominal CT confirmed the classic features of the Chilaiditi syndrome. Conservative management, which is the first option, resulted in improvement for this potentially severe entity. Clinicians should be aware of both the classical Chilaiditi sign and syndrome to avoid undue interventions.

Key words: Abdominal pain, Chilaiditi syndrome, Diagnosis, Radiology.