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Chilaiditi syndrome

Chilaiditi syndrome is one of the causes of pseudopneumoperitoneum and occurs when bowel gas is interposed between the liver and the hemidiaphragm resulting in pain. Gas in this position may be misinterpreted as true pneumoperitoneum resulting in further imaging, investigation and treatment that is not required.

Pain distinguishes Chilaiditi syndrome from colonic interposition.

Radiographic features

Plain radiograph

Features that suggest a Chilaiditi syndrome (termed the Chilaiditi sign) include:

  • gas between liver and diaphragm
  • rugal folds within the gas suggesting that it is within the bowel and not free

History and etymology

It is named after Dr Demetrius Chilaiditi (1883), Greek radiologist who described the radiographic findings in 1910 3; Vienna, Austria.

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