Chilaiditi's sign mimicking a traumatic diaphragmatic hernia

Abstract

A 75-year-old man had bruising develop after a traffic accident. A chest roentgenogram revealed elevation of the right hemidiaphragm. A subsequent computed tomographic scan showed interposition of the colon between the liver and diaphragm in front of the liver. Initially, we suspected a traumatic diaphragmatic hernia. Urgent exploratory video-assisted thoracoscopic surgery showed no injury of the right diaphragm. With the benefit of hindsight, there was no rupture of the diaphragm on the image. Hepato-diaphragmatic interposition of the colon is a very rare anomaly. This case was "Chilaiditi's sign" mimicking a traumatic diaphragmatic hernia.