Chilaiditi Syndrome: A Rare Case and Clinical Insights for Diagnosis and Management

Abstract

Chilaiditi syndrome is a rare medical condition characterized by the interposition of a hollow organ, usually the colon, between the liver and diaphragm, leading to abdominal pain, discomfort, bloating, constipation, or nausea; in more severe instances, respiratory symptoms may manifest due to pressure on the diaphragm. The exact cause remains unclear but is thought to present along with various factors such as anatomical anomalies (hepato-diaphragmatic interposition and intestinal malrotation) and chronic conditions (cirrhosis or chronic obstructive pulmonary disease). This case report presents a 78-year-old male with rapid deterioration, confusion, and mild abdominal discomfort. Clinical and radiological examinations confirmed Chilaiditi syndrome, highlighting the challenges in diagnosis. Management strategies range from conservative approaches to surgical interventions, emphasizing the need for increased clinical awareness among physicians to ensure accurate and timely interventions. This case report underscores the importance of recognizing this rare condition.

Keywords: chilaiditi syndrome; clinical awareness; diagnostic challenges; hepato-diaphragmatic interposition; radiological significance.

Figure 1. Thoracic X-ray with the red arrow indicating the raised hemicupola and colonic ansae beneath the diaphragm.

Figure 2. Abdominal X-ray displaying the anterior interposition of bowel loops in relation to the liver, indicated by the red arrow.

Figure 3. Abdominal CT scan revealing a colon loop between the diaphragm and the liver, as indicated by the red delineation.

CT: computed tomography