Chilaiditi's sign: A rare differential diagnosis of pneumoperitoneum

Ismail, Imen Ben; Zenaidi, Hakim; Rebii, Saber; Yahmadi, Abdelwahed; Zoghlami, Ayoub

doi:10.1002/ccr3.3346

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…6 The Chilaiditi sign can be mistaken for pneumoperitoneum due to the presence of subdiaphragmatic air. 7 Plain radiographs simulate pneumoperitoneum but computed tomography confirms this sign. 8,9 This predisposes to the decision of the need for surgical management of these patients, however, with the knowledge of this condition it is necessary to specify the differential diagnoses of each patient and avoid unnecessary surgery.…”

Section: Discussionmentioning

confidence: 99%

Chilaiditi's sign in complicated acute appendicitis: case report and literature review

Blaz Zavala,

García de Jesús,

Lagunas Cruz

et al. 2023

Int J Res Med Sci

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Chilaiditi's condition refers to the presence of a loop of small intestine or colon between the diaphragm and the hepatic rim, usually due to alterations in the attachment of the liver to the diaphragm. Chilaiditi syndrome is associated with abdominal pain as the most common clinical manifestation. Pneumoperitoneum should always be ruled out in the context of these patients. We presented the case of a male in his eighth decade of life who presented with data suggestive of drug-modified acute appendicitis, for which computed tomography of the abdomen identified acute appendicitis and Chilaiditi's condition. An open appendectomy was performed without complications and the condition resolved.

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Section: Discussionmentioning

confidence: 99%

Chilaiditi's sign in complicated acute appendicitis: case report and literature review

Blaz Zavala,

García de Jesús,

Lagunas Cruz

et al. 2023

Int J Res Med Sci

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“…This sign can be mistaken with a pneumoperitoneum, which signifies the presence of a perforated intra-abdominal bowel, particularly if accompanied by signs such as abdominal tenderness and guarding. Conversely, a pseudo-pneumoperitoneum describes the presence of intra-peritoneal air which appears as free, but in reality, it is contained within an organ [ 1 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Surgery procedure is only performed if the patient does not respond to the conservative treatment or there is evidence of bowel ischemia or mechanical bowel obstruction. Therefore, differentiating Chilaiditi’s syndrome with other causes of an acute abdomen, as well as careful monitoring during conservative treatment are very important in the management [ 2 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Pneumoperitoneum and Chilaiditi syndrome: navigating a diagnostic conundrum

Bourakkadi Idrissi,

Dkhissi

2024

Journal of Surgical Case Reports

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Chilaiditi sign represents a rare condition marked by the interposition of the bowel between the diaphragm and liver, mimicking pneumoperitoneum on radiological imaging. The syndrome manifests with gastrointestinal symptoms and is often confused with more serious conditions. This case report presents a rare instance of Chilaiditi syndrome, initially misdiagnosed as pneumoperitoneum based on chest X-ray findings. The patient, a 61-year-old woman, arrived at the emergency department complaining of acute epigastric pain. Initial tests, including a chest X-ray, suggested pneumoperitoneum, but a subsequent contrast-enhanced abdominal CT-scan revealed the interposition of the right colon between the liver and diaphragm, characteristic of Chilaiditi sign. The patient’s symptoms, including abdominal pain and diarrhea, were consistent with Chilaiditi syndrome. The patient was treated successfully with intravenous antibiotics and fluids, showing significant improvement within 48 hours. The report highlights the importance of differentiating Chilaiditi syndrome from other acute abdominal conditions to avoid unnecessary surgical intervention.

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“…Chilaiditi sign also called pseudo-pneumoperitoneum refers to the transposition of the bowel between the liver and diaphragm. 1 The usually interposed bowels are the hepatic flexure and the colon or the proximal transverse colon, while the small bowel is rarely involved. 2 Case Report 1 A 50 year old female who was a known case of Chronic obstructive pulmonary disease and Obstructive sleep apnea overlap syndrome who was on regular medication with metered dose inhaler (fluticasone + formoterol) came to the emergency with altered mentation and respiratory distress.…”

Section: Introductionmentioning

confidence: 99%

Non‐surgical pneumoperitoneum and pneumoretroperitoneum associated with mechanical ventilation

Ravi¹,

Sood²,

Gautam³

2022

JMV

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Chilaiditi's sign: A rare differential diagnosis of pneumoperitoneum

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 5 publications

References 10 publications

Chilaiditi's sign in complicated acute appendicitis: case report and literature review

Chilaiditi's sign in complicated acute appendicitis: case report and literature review

Pneumoperitoneum and Chilaiditi syndrome: navigating a diagnostic conundrum

Non‐surgical pneumoperitoneum and pneumoretroperitoneum associated with mechanical ventilation

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