06 November 2009
A rare case of Chilaiditi syndrome presenting “free air under diaphragm” and mimicking a perforated viscus
Ozgür Sogüt, Murat Orak, Mustafa Burak Sayhan, Mehmet Ustündag, Abdullah OzgonülAm J Case Rep 2009; 10:186-188 :: ID: 878249
Abstract
Background: Chilaiditi syndrome (CS) is the interposition of the right colon between the liver and the right hemidiaphragm. The incidence of CS in the general population is very low and it is seen more frequently in adults than in children. Here a case is presented of Chilaiditi syndrome presenting with abdominal pain and vomiting; its initial diagnosis was perforated viscus.
Case Report: A 36-year-old man was admitted to a state hospital with abdominal pain and vomiting which began three days before without any history of prior trauma. On chest x-ray, free air under the right hemidiaphragm was diagnosed as a perforated viscus. Upon physical examination in the authors’ hospital, his abdomen was distended, with normal bowel sounds, but no rebound tenderness were detected on palpation. CS was subsequently confirmed by a chest x-ray and abdominal ultrasound. The patient was managed conservatively and his symptoms resolved over the next 24 hours.
Conclusions: CS may be mistaken for more serious abnormalities, which may lead to unneeded exploratory abdominal surgery. This case emphasizes the importance of considering CS by emergency physicians or surgeons in the differential diagnosis of free air under the right hemidiaphragm on a chest x-ray.
Keywords: Abdominal Pain, chest x-ray, Chilaiditi syndrome, abdominal ultrasound
In Press
14 Mar 2024 : Case report
Eosinophilic Pleural Effusion Secondary to Trichinella spiralis Infection in a Patient with Systemic Sclero...Am J Case Rep In Press; DOI: 10.12659/AJCR.943420
14 Mar 2024 : Case report
Laparoscopic Sleeve Gastrectomy with Staple-Line Oversewing in a Patient with Factor XI Deficiency: A Case ...Am J Case Rep In Press; DOI: 10.12659/AJCR.942824
14 Mar 2024 : Case report
Pathogenic Potential of a PCK1 Gene Variant in Cytosolic PEPCK Deficiency: A Compelling Case StudyAm J Case Rep In Press; DOI: 10.12659/AJCR.943118
14 Mar 2024 : Case report
Management of Nontraumatic Spontaneous Renal Hemorrhage (Wünderlich Syndrome) through Robotic-Assisted Lapa...Am J Case Rep In Press; DOI: 10.12659/AJCR.942826
Most Viewed Current Articles
07 Mar 2024 : Case report
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
10 Jan 2022 : Case report
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case report
Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19DOI :10.12659/AJCR.936128
Am J Case Rep 2022; 23:e936128
23 Feb 2022 : Case report
Penile Necrosis Associated with Local Intravenous Injection of CocaineDOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250