Surgical Treatment of Chilaiditi Syndrome

Masakazu Fujii and Kazuya Nishida

Ajisu Dohjin Hospital

We report surgical treatment of Chilaiditi syndrome. An 81-year-old woman admitted for chest discomfort and appetite loss was found in chest and abdominal X-ray to have colonic gas in the right lower lung field. Chest and abdominal CT showed colonic gas in the right subphrenic space. Chilaiditi syndrome was diagnosed, and with her own and her family's approval, underwent surgery to ameliorate the symptoms. We fixed the right colonic flexure to the peritoneum on the right side after dissecting adhesion between the ascending and transverse colon. The postoperative course was uneventful, and the patient was discharged 21 days after surgery. Colonic Chilaiditi syndrome is generally asymptomatic, so most cases are simply followed up. The small intestinal type is often associated with intestinal strangulation, indicating surgery for symptomatic colonic Chilaiditi syndrome. Such surgery may not be difficult, but is often difficult to determine whether indicated.

Key words
Chilaiditi syndrome, hepatodiaphragmatic interposition of the colon, surgical indication

Reprint requests
Masakazu Fujii Ajisu Dohjin Hospital 4241-4 ajisu-chou, yoshiki-gun, Yamaguchi, 754-1214, JAPAN

Accepted
February 26, 2003

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