Chilaiditi syndrome

Description

Chilaiditi sign: the asymptomatic, usually incidental radiographic finding, in which a part of the intestine is located between the liver and the diaphragm. Hepatodiaphragmatic interposition of the intestine (HDI)

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Chilaiditi syndrome: symptomatic hepatodiaphragmatic interposition associated with abdominal pain, nocturnal vomiting, anorexia, and abdominal distension.

History

1866 – Arnoldo Cantani (1837-1893) first described the interposition of the intestine between the liver and the diaphragm on clinical examination in his Caso di fegato ambulante. Referenced by Schmidt’s Jahrbücher in 1869 as Fall von wandernder Leber and later by Rogers in 1935.

1899 – Antoine Béclère (1856-1939) presented autopsy and radiological findings in a patient thought to have a subdiaphragmatic abscess

1910 – Dimítrios Chilaiditi (1883-1975) reported the anatomo-radiographic findings of 3 asymptomatic cases of subdiaphragmatic air on plain XR as a result of temporary hepatodiaphragmatic interposition of the colon.

Associated Persons

• Arnoldo Cantani (1837-1893)
• Antoine Louis Gustave Béclère (1856-1939)
• Dimítrios Chilaiditi (1883-1975)

Alternative names

• Hepatodiaphragmatic interposition of the intestine (HDI)

References

• Cantani A. Caso di fegato ambulante. Annali universali di medicina 1866; 62(198): 373-382
• Cantani A. Fall von wandernder Leber. Schmidt’s Jahrbücher der in- und ausländischen gesammten Medicin. 1869; 141: 108
• Béclère A. Rectification d’une erreur de diagnostic; ectopie du colon transverse prise, a l’examen radioscopique, pour un abces gazeux sousphrenique. Bulletins et Mémoires de la Société médicale des hôpitaux de Paris. 1899; 16: 506-507. [PDF]
• Chilaiditi D. Zur Frage der Hepatoptose und Ptose im Allgemeinen im Anschluss an Drei Fälle von Temporärer, Partieller Leberverlagerung. Fortschritte auf dem Gebiete der Röntgenstrahlen. 1910; 16: 173-208
• Rogers JCT. Hepato-diaphragmatic interposition of the colon: Report of a case. Illinois Medical Journal. 1935; 68: 264-268.
• Vessal K, Borhanmanesh F. Hepatodiaphragmatic interposition of the intestine (Chilaiditi’s syndrome). Clin Radiol. 1976 Jan;27(1):113-6.
• Melester T, Burt ME. Chilaiditi’s Syndrome: Report of Three Cases. JAMA. 1985; 254(7): 944-945.
• Hountis P, Chounti M. Chilaiditi’s sign or syndrome? Diagnostic question in two patients with concurrent cardiovascular diseases. Monaldi Arch Chest Dis. 2017 Jul 18;87(2):775.
• Moaven O, Hodin RA. Chilaiditi Syndrome – A Rare Entity with Important Differential Diagnoses. Gastroenterol Hepatol (N Y). 2012; 8(4): 276–278.
• Nakagawa H, Toda N, Taniguchi M, Ibukuro K, Tagawa K. Prevalence and sonographic detection of Chilaiditi’s sign in cirrhotic patients without ascites. AJR Am J Roentgenol. 2006 Dec;187(6):W589-93.
• Sato M et al. Chilaiditi syndrome: sonographic findings. Abdom Imaging. 2000 Jul-Aug;25(4):397-9