Southwest Journal of Pulmonary and Critical Care (Oct 2016)

Medical image of the week: Chilaiditi syndrome

  • Makkar P ,
  • Mishra R ,
  • Upadhyay S

DOI
https://doi.org/10.13175/swjpcc077-16
Journal volume & issue
Vol. 13, no. 4
pp. 179 – 180

Abstract

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No abstract available. Article truncated at 150 words. X-ray evidence of air under right hemi-diaphragm in proper clinical context is almost a definitive sign of gastrointestinal tract perforation except in an extremely rare clinical entity called "Chilaiditi Syndrome". We present this unique image and clinical scenario to expand on physician`s knowledge to identify this rare clinical syndrome and to help distinguish it from a dreaded condition like gastrointestinal perforation. An 81-year-old man with multiple co-morbidities was admitted to the intensive care unit with a diagnosis of acute hypoxic respiratory failure. An X-ray of the chest showed a lucency under the right hemi-diaphragm interposed between the liver and diaphragm (Figure 1). Due to radiological concern of gastrointestinal perforation, an emergent CT scan was performed to rule out perforation. CT scan revealed gas filled distended hepatic flexure interposed between the elevated right hemi-diaphragm and the liver (Figure 2). The patient had no gastro-intestinal tract symptoms and no pathological signs were ...

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