Chilaiditi sign

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Abdominal pain

Patient Data

Age: 75 years
Gender: Male
ct

There is interposition of colonic loops between the right hemidiaphragm and liver with no free intraperitoneal gas representing Chilaiditi sign.

A few non-enhanced simple cortical cysts are seen in both kidneys, with maximum diameters of 20 mm. 

In imaged portions of lower thorax; patchy ill-defined, mostly subpleural, ground glass opacities and focal consolidations are seen in both lungs highly suggestive for COVID-19 pneumonia. Isolation and COVID-19 assay are recommended. 

The prostate gland is enlarged.

Case Discussion

The interposition of colon, between the right hemidiaphragm and liver is known as Chilaiditi sign. It may be misinterpreted as a true pneumoperitoneum resulting in unnecessary further investigations and/or therapy (so-called pseudopneumoperitoneum).

The presence of pain associated with and attributed to the sign is termed Chilaiditi syndrome.

The patient had positive RT-PCR testing for COVID-19.

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