Chilaiditi syndrome

Chilaiditi syndrome or subphrenic interposition of the colon, is a rare condition with an incidence of 0.025% - 0.28% in radiographs and mostly diagnosed as an incidental finding. We report the case of a 67-years-old male, heavy smoker, with history of intermittent abdominal pain, who reported cough and muco-purulent sputum without fever or dyspnea. Physical examination showed bilateral bronchial rales and right hypochondrium sensitivity, his vital signs were normal. A posteroanterior chest films (A) reveled an elevated right hemidiaphragm with free gas below. A pneumoperitoneum, subphrenic abscess, and intestinal pneumatosis were suspected, however, a CT scan of the thorax and abdomen (B, C and D) showed the interposition of the right colon angle between the diaphragm and the liver without any perforated viscus. Our patient was treated for chronic bronchitis infection; otherwise his Chilaiditi syndrome required symotomatic treatment with good outcomes.