Diagnosis of Chilaiditi's syndrome with abdominal ultrasound

Chilaiditi's sign is a radiographic term used when the hepatic flexure of t he colon is seen interposed between the liver and right hemidiaphragm. When symptomatic, this is Chilaiditi's syndrome.. We report a case of a 70-year -old man who presented with abdominal paint vomiting: singultus and constip ation. Ultrasound was initially performed which showed an intestinal loop b etween the anterior surface of the right liver lobe and the diaphragm. The chest X-ray revealed colon gas under the right diaphragma and the abdominal CT-scan confirmed the hepato-diaphragmatic interposition of the colon. Col onic elongation and laxity of colonic and hepatic suspensory ligaments are the principal predisposing factors. The advantages of the abdominal ultraso und in the diagnosis and follow-up as well as possible complications and fo rms of therapy with this syndrome are discussed.