Chilaiditi sign

Changed by Daniel J Bell, 28 Jun 2018

Updates to Article Attributes

Body was changed:

Chilaiditi sign refers to the interposition of bowel, usually colon, between the inferior surface of the right hemidiaphragm and the superior surface of the liver. It may be misinterpreted as a true pneumoperitoneum resulting in unnecessary further investigations and/or therapy. The presence of pain associated with and attributed to the sign is termed Chilaiditi syndrome.

Radiographic features

Plain radiograph

Features that suggest Chilaiditi sign include:

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

If there is a clinical suspicion of abdominal visceral perforation and plain radiographic appearances are unclear, abdominal CT can be performed to clarify whether there is pneumoperitoneum.

CT can clearly demonstrate the presence of interposed colonic loops between the right hemidiaphragm and liver with no free intraperitoneal air. 

Treatment and prognosis

Asymptomatic patients with Chilaiditi sign do not require further imaging or treatment.

History and etymology

It is named after Demetrius Chilaiditi (1883-1975) 1,Greek radiologist who described the radiographic findings in 1910 3 whilst working in Vienna, Austria. Although the first description of interposition of colon between the liver and the right hemidiaphragm was published by Cantini in 1865.

  • -</ul><h5>CT</h5><p>If there is a clinical suspicion of abdominal visceral perforation and plain radiographic appearances are unclear, abdominal CT can be performed to clarify whether there is pneumoperitoneum.</p><p>CT can clearly demonstrate the presence of interposed colonic loops between the right hemidiaphragm and liver with no free intraperitoneal air. </p><h4>Treatment and prognosis</h4><p>Asymptomatic patients with Chilaiditi sign do not require further imaging or treatment.</p><h4>History and etymology</h4><p>It is named after<strong> Demetrius </strong><strong>Chilaiditi </strong>(1883-1975) <sup>1</sup>,<strong> </strong>Greek radiologist who described the radiographic findings in 1910 3 whilst working in Vienna, Austria. Although the first description of interposition of colon between the liver and the right hemidiaphragm was published by Cantini in 1865.</p><h4> </h4>
  • +</ul><h5>CT</h5><p>If there is a clinical suspicion of abdominal visceral perforation and plain radiographic appearances are unclear, abdominal CT can be performed to clarify whether there is pneumoperitoneum.</p><p>CT can clearly demonstrate the presence of interposed colonic loops between the right hemidiaphragm and liver with no free intraperitoneal air. </p><h4>Treatment and prognosis</h4><p>Asymptomatic patients with Chilaiditi sign do not require further imaging or treatment.</p><h4>History and etymology</h4><p>It is named after<strong> Demetrius </strong><strong>Chilaiditi </strong>(1883-1975) <sup>1</sup>,<strong> </strong>Greek radiologist who described the radiographic findings in 1910 3 whilst working in Vienna, Austria. Although the first description of interposition of colon between the liver and the right hemidiaphragm was published by Cantini in 1865.</p>

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