Hypoganglionic megacolon associated Chiliaditi's syndrome treated by subtotal colectomy: a case report

In 1910, Chiliaditi described hepatodiaphragmatic interposition of the colo n (Chiliaditi's syndrome). The condition is easily recognised on an antero- posterial chest radiograph. The interposed segment of bowel is usually the hepatic flexure of the colon. The degree of interposition varies from simpl e wedging to complete occupation of the right subdiaphragmatic space. The m anagement is usually conservative and surgical intervention is rarely indic ated. We present a patient with hepatodiaphragmatic interposition of the co lon, associated with megacolon, requiring subtotal colectomy and ileosigmoi d anastomosis for severe chronic constipation.