Chilaiditi sign
Today, I learned about the Chilaiditi sign.
Chilaiditi sign refers to the interposition of the bowel, usually colon, between the inferior surface of the right hemidiaphragm and the superior surface of the liver. It may be misinterpreted as a true pneumoperitoneum resulting in unnecessary further investigations and/or therapy (so-called pseudopneumoperitoneum).
In incidental finding in the chest and abdominal radiographs with an incidence of about 0.025 to 0.28%, with a male to female ratio of 4:1, where there is bowel, usually colon interposed between the liver and diaphragm.
The following criteria must be met before making the diagnosis of Chilaiditi sign:
- elevation of the right hemidiaphragm
- distended colonic loops between the right cupola and the liver
- superior border of the liver inferior to the level of the left hemidiaphragm
This syndrome was first defined in 1910 by Demetrius Chilaiditi, a Greek radiologist, after he reported three cases of patients who were found to have intra-abdominal free air on radiological imaging caused by the interposition of the bowel between the right hemidiaphragm and liver.
Day 35 of #100DaysToOffload. Find out more about it here.
References:
Chilaiditi sign. https://radiopaedia.org/cases/chilaiditi-sign-14?lang=us
Chilaiditi sign. https://radiopaedia.org/articles/chilaiditi-sign
Chilaiditi Syndrome. Kumar A, Mehta D. Chilaiditi Syndrome. [Updated 2022 Apr 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554565/