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Article Abstract
A 47-year-old woman, a diagnosed case of syndrome of inappropriate secretion of antidiuretic hormone, underwent 18 F-FDG PET/CT to detect occult malignancy for suspected paraneoplastic etiology. Abnormal FDG uptake was noted in the right lower chest region, which was correlated on corresponding CT images to be colonic activity interposed between the liver and elevated diaphragm, also known as Chilaiditi sign. Even though rare, Chilaiditi sign should be considered as a differential diagnosis of hypermetabolic activity in the right lower chest region on 18 F-FDG PET/CT scan that is done to look for occult tumor as shown in this case.
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[Chilaiditi's syndrome-A rare anatomical variant of the colon].
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Chilaiditi's sign is a rare, usually asymptomatic anatomical variant in which a segment of the colon, most commonly the transverse colon, is interposed between the diaphragm and the liver. This interposition can be misinterpreted as a pneumoperitoneum on radiographic imaging, which therefore poses diagnostic challenges. While many cases are discovered incidentally and require no treatment, symptoms such as abdominal pain, nausea or constipation can occur.
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Department of Surgery, Hospital Sant' Antonio AOPD, University of Padua, Padua, Italy.
Chilaiditi's sign consists of the interposition of a segment of the intestine between the right diaphragm and the liver; when this anomaly causes gastrointestinal symptoms, it is referred to as Chilaiditi's syndrome. If conservative treatment fails, surgical intervention is often necessary, especially in severe or complicated cases. An 82-year-old woman with a 2-year history of right-sided abdominal pain, constipation, malaise, and weight loss was diagnosed with Chilaiditi's syndrome following an extensive workout to exclude other pathologies.
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Gastroenterology, Borland Groover, Jacksonville, USA.
Chilaiditi syndrome is an uncommon and often misdiagnosed condition characterized by the interposition of the colon between the liver and diaphragm, leading to symptoms of abdominal pain, bloating, and bowel dysfunction. Risk factors include chronic constipation, anatomical variations, and diaphragmatic dysfunction. This report presents the case of a 67-year-old male with right upper quadrant discomfort exacerbated by stool retention.
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Clinical Pathology Department, Unidade Local de Saúde do Nordeste, Unidade Hospitalar de Bragança, Bragança, PRT.
The Chilaiditi sign is the presence of a loop of bowel interposed between the liver and the diaphragm. In most cases, the Chilaiditi sign is diagnosed as a rare incidental radiological finding on chest X-rays or the abdomen of asymptomatic patients. When associated with symptoms, it is named Chilaiditi syndrome.
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