Transverse Colon Volvulus and Chilaiditi Syndrome: An Exceptional Association

Nofuentes, Carmen; Mella, Mario; Soliveres, Edelmira Soliveres; Pérez-Bru, Susana; Marín, Andrés García; García-García, Salvador

doi:10.1177/000313481107701114

Cited by 10 publications

(7 citation statements)

References 3 publications

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“…55,56 In addition, Chilaiditi syndrome, which is characterized by a loop of colon between the liver and the right hemidiaphragm, has been cited as a risk factor for volvulus. 57,58 The splenic flexure has several attachments and is typically immobile. Volvulus of the splenic flexure occurs more commonly in the setting of chronic constipation, similar to transverse colon volvulus, and previous abdominal surgery.…”

Section: Transverse Colon and Splenic Flexure Volvulusmentioning

confidence: 99%

Volvulus of the Small Bowel and Colon

Kapadia

2016

Clinics in Colon and Rectal Surgery

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Volvulus of the intestines may involve either the small bowel or colon. In the pediatric population, small bowel volvulus is more common, while in the adult population, colonic volvulus is more often seen. The two most common types of colonic volvulus include sigmoid and cecal volvulus. Prompt diagnosis and treatment is imperative, otherwise bowel ischemia may ensue. Treatment often involves emergent surgical exploration and bowel resection.

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Section: Transverse Colon and Splenic Flexure Volvulusmentioning

confidence: 99%

Volvulus of the Small Bowel and Colon

Kapadia

2016

Clinics in Colon and Rectal Surgery

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“…Falciform ligament hernias have previously been described and may contain small or large bowel though usually through a defect in the ligament. 13 This case was unusual in that the hepatodiaphragmatic interposition contained splenic flexure 15 as opposed to transverse colon 2,3,5,7–12 or sigmoid colon. 4 This was a consequence of the intestines rotating only 90 deg during foetal development placing the caecum in the left iliac fossa to the left of the small intestine enabling the splenic flexure to gain access to the right subdiaphragmatic space.…”

Section: Discussionmentioning

confidence: 97%

“…Furthermore, colonic volvulus causing bowel obstruction in an adult with Chilaiditi's syndrome has been reported only eleven times in the world literature. 2–12 We describe the twelfth such case and believe this is the first reported case associated with adult malrotation.…”

Section: Introductionmentioning

confidence: 83%

“…In nine of the previously reported cases of Chilaiditi's syndrome with colonic volvulus, treatment was by partial colonic resection 2–7,10–12 Three of these patients underwent stoma formation 2,4,5 and there was one mortality from anastomotic leak following primary anastomosis. 7 In this case, we judged that in the absence of ischaemia, colonic resection would have been excessive and unnecessary.…”

Section: Discussionmentioning

confidence: 99%

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Chilaiditi's syndrome associated with colonic volvulus and intestinal malrotation—A rare case

Williams

Cox

Palaniappan

et al. 2014

International Journal of Surgery Case Reports

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INTRODUCTIONChilaiditi's syndrome (symptomatic hepatodiaphragmatic interposition of the colon) is an exceptionally rare cause of bowel obstruction and may present difficulty in diagnosis and management. This is the first reported case of colonic volvulus occurring in Chilaiditi's syndrome in association with intestinal malrotation and this case study describes its successful management.PRESENTATION OF CASEAn 18 year old male presented as an emergency with vague abdominal pain and a past history of gastroschisis repair with intestinal malrotation. CT scanning showed a closed loop obstruction due to a volvulus of the colon herniating under the falciform ligament. The patient was successfully treated by surgical reduction of the hernia, anatomical correction of the malrotation and caecopexy with a tube caecostomy. At six month follow up the patient was well and asymptomatic.DISCUSSIONIn nine of the previously reported cases of Chilaiditi's syndrome with colonic volvulus, treatment was by partial colonic resection of which a third underwent stoma formation. One patient died as a consequence of anastomotic leak following primary anastomosis. We therefore suggest an alternative approach to management.CONCLUSIONChilaiditi's syndrome with colonic volvulus in association with intestinal malrotation has not previously been described. As there is no consensus in the literature as to how to manage such a case we suggest that reduction of the volvulus, anatomical correction of the malrotation and fixation of the caecum by tube caecostomy results in a successful outcome. This approach avoids the need for colonic resection and possible stoma formation.

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“…A noninterventional approach can reliably be adopted for an incidental finding of Chilaiditi's sign. Chilaiditi's Syndrome, however, should be treated conservatively by bed rest, nasogastric decompression, stool softeners and intravenous hydration [ 4 , 6 , 7 ]. Emergency operative surgery is indicated if there are signs of intestinal obstruction, bowel ischaemia, perforation or subdiaphragmatic appendicitis [ 4 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

The air up there - Chilaiditi's syndrome: A case report and review of the literature

Tariq¹,

Pillay²

2020

African Journal of Emergency Medicine

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Chilaiditi’s sign is the presence of radiolucency in the subdiaphragmatic space as a result of colonic interposition, often misdiagnosed as a pneumoperitoneum. It is caused by anatomical variations that result in transpositioning of bowel within the subdiaphragmatic space. Chilaiditi’s syndrome is the presentation of cardiac, respiratory or abdominal symptoms accompanied by Chilaiditi’s sign. Symptomatic patients are managed with surgical intervention with the literature suggesting various resective and non-resective techniques to correct the anatomical defect. In this case an open right hemicolectomy was performed in attempt to remove the transpositioning bowel and a hepatopexy was performed to prevent any further reoccurrence of the syndrome. This case report highlights the diagnostic dilemma and management of Chilaiditi’s syndrome in a resource constrained Sub-Saharan Hospital.

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Transverse Colon Volvulus and Chilaiditi Syndrome: An Exceptional Association

Cited by 10 publications

References 3 publications

Volvulus of the Small Bowel and Colon

Volvulus of the Small Bowel and Colon

Chilaiditi's syndrome associated with colonic volvulus and intestinal malrotation—A rare case

The air up there - Chilaiditi's syndrome: A case report and review of the literature

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