Presentation
Right sided abdominal pain. Previous history of appendectomy. No fever or abnormal blood tests.
Patient Data
Non-contrast abdomen and pelvis CT showing the right colonic angle interposed between the liver and the anterior portion of the right diaphragm. There is normal fecal content along the colon, especially in the ascending colon. The remainder exam is unremarkable.
Please note that the axial images were reformatted with thick slices and thus there are some artefactual hyperintense foci along the diaphragms.
Case Discussion
Despite the not so prominent interposition of the colon between the diaphragm and the liver, this case was managed as a Chilaiditi syndrome based in both the clinical and imaging data. It was treated conservatively with analgesia and later improvements of the symptoms.