Air under the diaphragm—perforation or Chilaiditi sign?

Abstract

Chilaiditi sign is a rare radiological finding in which the colon is interposed between the liver and the abdominal wall. Once patients become symptomatic, the condition is called Chilaiditi syndrome. We discuss a unique patient who presented with intermittent abdominal pain for 2 years that worsened 6 months before presentation. Her radiological evaluation revealed Chilaiditi sign. She was treated conservatively and the sign resolved. We emphasize the importance of conservative management in Chilaiditi syndrome.

Keywords:

• Chilaiditi anomaly
• Chilaiditi sign
• Chilaiditi syndrome
• hepatodiaphragmatic interposition
• pneumoperitoneum