Case of Chilaiditi syndrome in a critically ill patient

Chilaiditi sign, a condition first described by Greek radiologist Demetrius Chilaiditi in 1910, is the radiological appearance of colonic interposition between the liver and the diaphragm. The incidence in chest/abdominal x-rays and CT scans is 0.025 – 0.28%. When there are symptoms, such as abdominal pain, nausea, constipation or respiratory distress, the condition is called Chilaiditi's syndrome. One of the key factors in the development of this anomaly is anatomic variation in the suspensory ligaments of the intestines. Other important etiological factors include aerophagia, constipation, liver cirrhosis and chronic lung disease with increased intrathoracic pressure. Below we discuss a case of Chilaiditi's syndrome in an elderly female, who presented with shortness of breath, constipation and abdominal distention. The diagnosis of Chilaiditi's syndrome was made by chest x-ray and CT scan.