What is the Chilaiditi sign (interposition of the colon)?

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From the Research

Chilaiditi sign is a rare radiological finding that is typically asymptomatic and requires no specific treatment, but if symptoms occur, it is termed Chilaiditi syndrome and may require conservative management with dietary modifications, bowel rest, intravenous fluids, and stool softeners, as seen in a recent case report 1.

Key Points

  • Chilaiditi sign is a rare condition where the colon or small intestine is abnormally positioned between the liver and the diaphragm, often discovered incidentally on imaging studies like chest X-rays or CT scans 2.
  • The condition is typically asymptomatic, but if symptoms occur, such as abdominal pain, nausea, vomiting, or constipation, it is termed Chilaiditi syndrome and may require management 3.
  • The hallmark radiological feature is the presence of gas below the diaphragm with visible haustra (colon markings), which helps differentiate it from pneumoperitoneum 4.
  • It is essential to distinguish this benign condition from more serious issues like pneumoperitoneum (free air in the abdomen), as misdiagnosis could lead to unnecessary surgical procedures 5.
  • Patients with this finding should be educated about its benign nature to prevent unnecessary concern, and conservative treatment is often successful, as seen in a case report of a pregnant woman with Chilaiditi syndrome 5.

Management

  • Asymptomatic Chilaiditi sign requires no specific treatment.
  • Chilaiditi syndrome may require management with dietary modifications, bowel rest, intravenous fluids, and stool softeners.
  • In rare severe cases, surgical intervention might be necessary.
  • Conservative treatment is often successful, and early diagnosis and treatment can minimize maternal and fetal complications, avoid unnecessary explorations, and shorten hospitalization 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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