Chilaiditi sign

Case contributed by Bruno Di Muzio
Diagnosis certain


Right upper quadrant pain.

Patient Data

Age: 85 years
Gender: Male

Chest radiograph


Lungs and pleural space are clear, no features to suggest infection. Cardiomediastinal contours are unremarkable and stable compared to the previous imaging. No pneumothorax or subphrenic free gas. Mild gaseous distension of the colon hepatic flexure, which is interposed between the liver and undersurface of the diaphragm.

Case Discussion

Chilaiditi syndrome is the anterior interposition of the colon to the liver reaching the under-surface of the right hemidiaphragm with associated upper abdominal pain. This is a clinical diagnosis based on imaging appearances and lack of other causes to explain the pain. 

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