Surgical management of large bowel obstruction and significant hepatic displacement caused by Chilaiditi syndrome

Abstract

Chilaiditi’s sign is the presence of pseudopneumoperitoneum caused by colonic distension and interposition with the liver on radiographic films. Most patients with Chilaiditi’s sign are asymptomatic. Chilaiditi’s syndrome is defined as the development of abdominal pain or symptoms of bowel obstruction along with the presence of Chilaiditi’s sign. It is a rare entity and it poses significant diagnostic challenges due to its similar radiographic appearance to pneumoperitoneum. Most patients with Chilaiditi syndrome can be managed conservatively. However, surgery is indicated for those who do not respond to conservative management or for suspicion of severe complications such as bowel ischaemia or perforation. In this case report, we described the surgical management of a patient who presented with bowel obstruction and significant hepatic displacement from Chilaiditi syndrome.