Chilaiditi Syndrome Mimicking Subdiaphragmatic Free Air in an Elderly Adult

Ho, Min Po; Cheung, Wing Keung; Tsai, Kaung-Chau; Chou, An Hsun

doi:10.1111/jgs.13052

Cited by 3 publications

(5 citation statements)

References 4 publications

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“…Moreover, there are many other factors mentioned, such as: obesity, ascites, chronic constipation, internal hernia, multiple labor, intestinal obstruction, aerophagia, especially in mentally ill, and others (1, 2, 5, 6, 8, 22) . Intestinal translocation between the diaphragm and the liver may be of a transitional or permanent nature.…”

Section: Discussionmentioning

confidence: 99%

“…gastric volvulus (2,6,21) . The Chilaiditi syndrome is observed with the frequency of 1 per 50,000 people (8) and seldom following unsuccessful conservative therapy it requires surgical intervention aimed at preventing necrosis or intestine perforation (1,4,6,(13)(14)(15)21) . An important issue is that at the moment of finding gas below the diaphragm on the right, the differentiation should account for several pathologies: free gas in the peritoneum, interposition of the intestine, subdiaphragmatic abscess, abscess of the liver with gas, Morgagni hernia and interposition of the intestine above the diaphragm after traumatic rupture.…”

Section: Discussionmentioning

confidence: 99%

“…The last term covers mainly unusual location of the intestine between the diaphragm and the liver, which in literature is termed the Chilaiditi sign (named after the surname of the author of the first publication on the subject matter). The clinical and radiological symptomatology distinguishes also the Chilaiditi syndrome which indicates the existence of a causal link between the existing diaphragm-liver intestinal interposition and various ailments as regards the gastrointestinal tract, respiratory and/or circulatory system (1,2,(6)(7)(8)(9)(10) . Ultrasonography is rarely applied in differentiating pneumoperitoneum with the Chilaiditi sign (4,(11)(12)(13)(14)(15) .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Czy ultrasonograficznie można odróżnić pseudopneumoperitoneum od podobnych patologii?

Smereczyński

Kołaczyk

2017

J Ultrason

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AimThe goal of the work was comparing gas ultrasound images below the right diaphragm in two groups: in people with intestinal interposition below the diaphragm and ones with pneumoperitoneum and extracting the traits differentiating these two conditions.Material and methodsRetrospectively, the documentation of 22 patients with intestinal interposition below the diaphragm (group 1) was utilized. Clinical material was used for comparison, previously published, composed of 15 cases of pneumoperitoneum following laparotomy and of 14 cases following that symptom as a result of ulcer perforation – group 2 (in total n = 29). Moreover, the distance in millimeters of the gas surface reflecting ultrasounds from the parietal peritoneum was measured, the smoothness of the surface, parietal peritoneum enhancement at the place of gas adherence, gas continuity below the diaphragm with gas in the intestine located below the liver.ResultsDirect adherence of the gas surface to the diaphragm was observed in 100% of the cases of emphysema, but in no cases of intestinal interposition. Yet, in the group of patients with colonic interposition (n = 21) there was always a small gap (2–3 mm) and the gas surface among those patients in 100% of the cases was uneven.ConclusionsIn differentiation between pneumoperitoneum and liver-diaphragm interposition of the intestine one should take into account – apart from gas movement below the diaphragm at body position changing – the presence of protrusion and section enhancement of the diaphragmatic peritoneum as well as the distance of the gas from the diaphragm, the smoothness of its surface and the continuity with the intestine below the liver. Interpositions of small diaphragm-liver penetration may subside in erect position.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Czy ultrasonograficznie można odróżnić pseudopneumoperitoneum od podobnych patologii?

Smereczyński

Kołaczyk

2017

J Ultrason

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“…The radiologist raised the suspicious of air under the left diaphragmatic dome (oval shape); CT was performed and confirmed the presence of small bowel occlusion and perforation. -Chilaiditi's phenomenon 31 : gas forms a crescent shape under the right hemidiaphragm, which is thickened; this phenomenon occurs in patients with small liver or flattened diaphragms, in whom these conditions are responsible of the creation of a space within the upper abdomen above the liver and this space may be filled by bowel, whose air content may mimic free gas; and -false Rigler's sign due to the presence of adjacent bowel loops that contain air; the imaging appearance is the presence of air on both sides of the bowel wall, as in Rigler sign. 28 …”

Section: Plain Film Techniquementioning

confidence: 99%

Small Bowel Perforations: What the Radiologist Needs to Know

Mantia

Picone

et al. 2016

Seminars in Ultrasound, CT and MRI

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The incidence of small bowel perforation is low but can develop from a variety of causes including Crohn disease, ischemic or bacterial enteritis, diverticulitis, bowel obstruction, volvulus, intussusception, trauma, and ingested foreign bodies. In contrast to gastroduodenal perforation, the amount of extraluminal air in small bowel perforation is small or absent in most cases. This article will illustrate the main aspects of small bowel perforation, focusing on anatomical reasons of radiological findings and in the evaluation of the site of perforation using plain film, ultrasound, and multidetector computed tomography equipments. In particular, the authors highlight the anatomic key notes and the different direct and indirect imaging signs of small bowel perforation.

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“…First described by Greek radiologist Demetrius Chilaiditi in 1910, Chilaiditi syndrome is a rare occurrence with an incidence rate of 0.25%-0.28% in the general population. 2 The etiology of Chilaiditi syndrome is felt to be congenital or acquired with predisposing congenital abnormalities such as absent suspensory or falciform ligaments, redundant colon, malposition of the colon, dolichocolon, and paralysis of the right diaphragm. Other risk factors for development of Chilaiditi syndrome include chronic constipation, cirrhosis, ascites, and obesity.…”

Section: Answer To: Image 1: Chilaiditi Syndromementioning

confidence: 99%