Chilaiditi Syndrome: An Incidental Finding on a Chest Radiograph in a Long-Term Ventilated Patient

Abstract

Background: Chilaiditi syndrome is a situation with a structural impingement of the colon on the liver, leading to an elevated hemidiaphragm in the X-ray along with a gas-like ap-pearance in the right hemithorax. It is generally a benign disease that is managed conservatively upon diagnosis. Rarely, it can be a cause of intestinal obstruction. Chilaiditi syndrome was origi-nally named after Demetrius Chilaiditi, the Greek radiologist who first described the case in 1910 while working in Vienna. Case Presentation:: Here, we have described the case of a 76-year-old male who was admitted to our long-term care facility for chronic respiratory failure, and he was connected to mechanical ventilation via tracheostomy. He was having occasional bouts of constipation, and was on regular laxatives. In a CT chest film done because of very thick respiratory secretions and desaturation, an incidental finding of Chilaiditi syndrome was noted. The patient has been managed conservatively with laxatives and per-need enemas. Chilaiditi syndrome is a rare condition in which the colon interposes between the liver, right hem-idiaphragm, and the abdominal wall, causing occasional clinical symptoms. Conversely, radio-graphic findings without clinical symptoms are known to exhibit the Chilaiditi sign. The disease's prevalence is estimated to be somewhere between 0.025 and 0.28%. Conclusion: Chilaiditi syndrome is a syndrome that refers to the interposition of the colon upon the hepatic flexure. It is a very rare but a serious cause of constipation, resulting in severe symp-toms to the extent that they may warrant surgical intervention.