One week of cough. Advised for a chest x-ray as the initial investigation.
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Interposition of the bowel loop (hepatic flexure of colon) between the right hemidiaphragm and liver.
Normal findings in the chest.
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Incidental finding of colonic interposition (Chilaiditi sign) on a chest x-ray.
This finding is of significance in patients who require percutaneous transhepatic interventional procedures such as liver biopsy, tumor ablation therapy and biliary drainage to avoid the risk of intestinal injury. Cirrhotic patients generally require these procedures as they are predisposed to HCC and gallstones.