Three Cases of Chilaiditi's Syndrome. Hepatodiaphragmatic Interposition of the Colon.

Naito, Michitaka; Funaki, Chiaki; Miura, Satoru; Yoshimine, Noboru; Kuzuya, Fumio

doi:10.3143/geriatrics.29.586

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…Causes of CS are mainly classi ed as follows [30][31] : Bowel factor i) huge colon or abnormally increased intestinal gas; or ii) oating colon; Diaphragmatic factor: i) high diaphragmatic position due to muscle atrophy or degeneration; ii) diaphragmatic paresis due to diaphragmatic nerve distress; or iii) changing pressure in the thorax or dilation of the inferior thoracic aperture; and Hepatic i) dropping liver; ii) liver atrophy; iii) ligament weakness; or iv) adhesion of the liver.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Yield of Chilaiditi’s Sign in Advanced-Phase Late-Onset Pompe Disease

Takahashi

Mori‐Yoshimura

Ariga

et al. 2022

JND

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Purpose: Chilaiditi’s sign (CS), hepatodiaphragmatic interposition of the intestine, was caused by morphological abnormalities such as diaphragmatic atrophy, intestinal dilation, and liver atrophy. The sign is potentially important due to associations with clinically recurrent abdominal pain or even colonic volvulus. Late-onset Pompe disease (LOPD) could have the high prevalence of CS because of widened hepatodiaphragmatic space, following diaphragmatic atrophy, and the abnormal dilation of intestine caused by glycogen accumulation in smooth muscle of intestine. Our aim was to investigate the prevalence of CS in LOPD, and to identify the risk factors of CS in LOPD patients. Methods: Medical records of genetically confirmed patients of Pompe disease at the National Center Hospital, National Center of Neurology and Psychiatry were retrospectively reviewed. We evaluated CS using chest X-ray (CXR) and abdominal CT and assessed the prevalence of CS in LOPD patients. We also divided the patients into two groups, CS and non-CS group, and evaluated the factor associated with CS compared to clinical variables between groups. Results: Three of seven (43%) were detected in CS. CS group (P5-7) and non-CS group (P1-4) were obtained. In comparison of clinical variables, the severity of atrophy in right diaphragms was significantly higher in CS than non-CS groups (p = 0.029). Also, the frequency of abnormal position of right diaphragm and liver, and abnormally dilated bowel was seen in all of CS patients, but none of non-CS patient (p = 0.029, each). Conclusion: In LOPD patients, the prevalence of CS was much higher of 43%, compared to healthy groups, or even in similarly respiratory muscle impaired neuromuscular diseases. The anatomically abnormal position of diaphragm and liver, atrophy and fat infiltration of diaphragms, and abnormally dilated bowel were significantly associated with CS in LOPD. We should pay more attention to CXR or abdominal CT as follow up in LOPD patients.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Yield of Chilaiditi’s Sign in Advanced-Phase Late-Onset Pompe Disease

Takahashi

Mori‐Yoshimura

Ariga

et al. 2022

JND

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Diagnostic Yield of Chilaiditi’s Sign in Advanced-Phase Late-Onset Pompe Disease

Takahashi

Mori‐Yoshimura

Ariga

et al. 2021

Preprint

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Purpose: Chilaiditi’s sign (CS), hepatodiaphragmatic interposition of the intestine, was caused by morphological abnormalities such as diaphragmatic atrophy, intestinal dilation, and liver atrophy. The sign is potentially important due to associations with clinically recurrent abdominal pain or even colonic volvulus. In general, neuromuscular disease (NMD) could have the high prevalence of CS because of widened hepatodiaphragmatic space, following diaphragmatic atrophy. Particularly, in late-onset Pompe disease (LOPD), glycogen accumulation in smooth muscle of intestine could lead to the abnormal dilation of intestine. Though the prevalence of CS in LOPD could be high because of developing two main factors of CS, no studies have evaluated the prevalence of CS in LOPD. Our aim was to investigate the prevalence of CS in LOPD, and to identify the risk factors of CS in LOPD patients. Methods: Medical records of genetically confirmed patients of Pompe disease at the National Center Hospital, National Center of Neurology and Psychiatry were retrospectively reviewed. We evaluated CS using chest X-ray (CXR) and abdominal CT and assessed the prevalence of CS in LOPD patients. We also divided the patients into two groups, CS and non-CS group, and evaluated the factor associated with CS compared to clinical variables between groups. Results: Three of seven (43%) were detected in CS. CS group (P5-7) and non-CS group (P1-4) were obtained. In comparison of clinical variables, the severity of atrophy in right diaphragms was significantly higher in CS than non-CS groups (p =0.029). Also, the frequency of abnormal position of right diaphragm and liver, and abnormally dilated bowel was seen in all of CS patients, but none of non-CS patient (p = 0.029, each). Conclusion: In LOPD patients, the prevalence of CS was much higher of 43%, compared to healthy groups, or even in similarly respiratory muscle impaired neuromuscular diseases such as Duchenne muscular dystrophy (DMD) or Myotonic dystrophy type 1 (DM1). The anatomically abnormal position of diaphragm and liver, atrophy and fat infiltration of diaphragms, and abnormally dilated bowel were significantly associated with CS in LOPD. Since CS can cause intestinal symptoms or even contribute to sudden-death of intestinal volvulus, we should pay more attention to CXR or abdominal CT as follow up in LOPD patients.

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Chilaiditi's syndrome demonstrated by SPECT/CT

et al. 2009

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Purpose: Chilaiditi’s syndrome is a rare condition commonly diagnosed as an incidental radiological finding. The aim of this report is to show the role of SPECT-CT in this syndrome and state the functional and anatomical role of this hybrid imaging modality. Materials and Methods: A case report. Results: A 49-year-old female patient was referred for gallium-67 citrate for a possible granulomatous myositis and underwent SPECT-CT of the abdomen to assess the area of decreased gallium uptake on planar images of the liver. The combined SPECT and CT modality demonstrated findings consistent with the clinical evidence of Chilaiditi’s syndrome. The anatomical part of this hybrid modality made it easier to evaluate the area of gallium lack of uptake which was due to air in the colon. Conclusion: This case does not only show the role of SPECT-CT in this syndrome but also suggest that the use of such modality should be considered whenever available in the evaluation of patients in whom the localization of active disease becomes imperative.

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Three Cases of Chilaiditi's Syndrome. Hepatodiaphragmatic Interposition of the Colon.

Cited by 3 publications

References 5 publications

Diagnostic Yield of Chilaiditi’s Sign in Advanced-Phase Late-Onset Pompe Disease

Diagnostic Yield of Chilaiditi’s Sign in Advanced-Phase Late-Onset Pompe Disease

Diagnostic Yield of Chilaiditi’s Sign in Advanced-Phase Late-Onset Pompe Disease

Chilaiditi's syndrome demonstrated by SPECT/CT

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