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Case Reports: Rare disease
Surgical management of large bowel obstruction and significant hepatic displacement caused by Chilaiditi syndrome
  1. Chien-Tse Kao1,
  2. Margaret Dunkley2 and
  3. Russell Hodgson1
  1. 1Surgery, Northern Hospital Health Sciences Library, Epping, Victoria, Australia
  2. 2General Surgery, Mildura Base Public Hospital, Mildura, Victoria, Australia
  1. Correspondence to Russell Hodgson; russell.hodgson{at}nh.org.au

Abstract

Chilaiditi’s sign is the presence of pseudopneumoperitoneum caused by colonic distension and interposition with the liver on radiographic films. Most patients with Chilaiditi’s sign are asymptomatic. Chilaiditi’s syndrome is defined as the development of abdominal pain or symptoms of bowel obstruction along with the presence of Chilaiditi’s sign. It is a rare entity and it poses significant diagnostic challenges due to its similar radiographic appearance to pneumoperitoneum. Most patients with Chilaiditi syndrome can be managed conservatively. However, surgery is indicated for those who do not respond to conservative management or for suspicion of severe complications such as bowel ischaemia or perforation. In this case report, we described the surgical management of a patient who presented with bowel obstruction and significant hepatic displacement from Chilaiditi syndrome.

  • Gastrointestinal surgery
  • Radiology

https://doi.org/10.1136/bcr-2023-255047

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results and critical revision for important intellectual content: C-TK, MD, RH. The following authors gave final approval of the manuscript: C-TK, MD, RH.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.