Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2018; 6(15): 1042-1046
Published online Dec 6, 2018. doi: 10.12998/wjcc.v6.i15.1042
Intermittent abdominal pain accompanied by defecation difficulties caused by Chilaiditi syndrome: A case report
Xia-Gang Luo, Jing Wang, Wu-Lin Wang, Chun-Zhao Yu
Xia-Gang Luo, Jing Wang, Wu-Lin Wang, Chun-Zhao Yu, Department of General Surgery, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
Author contributions: Luo XG wrote the paper; Wang J, Wang WL collected the data and relevant images; Yu CZ revised the paper.
Supported by the National Natural Science Foundation of China, No. 30972910, 81172269; Jiangsu Provincial Commission of Health and Family Planning, No. Z201603; Science and Technology Development Fund of Nanjing Health and Family Planning Commission, No. YKK16233; Youth talent support program of Nanjing City during the 13th Five-Year Plan Period, No. QRX17107.
Informed consent statement: The patient was not required to give informed consent as the analysis included completely anonymous data; informed consent was obtained before any medical investigation or initiation of treatment as required.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chun-Zhao Yu, MD, PhD, Professor, Department of General Surgery, the Second Affiliated Hospital of Nanjing Medical University, No. 121 Jiangjiayuan Road, Nanjing 210011, Jiangsu Province, China. chunzhaoyu@njmu.edu.cn
Telephone: +86-25-58509832 Fax: +86-25-58509994
Received: September 12, 2018
Peer-review started: September 12, 2018
First decision: October 11, 2018
Revised: October 18, 2018
Accepted: October 22, 2018
Article in press: October 22, 2018
Published online: December 6, 2018
Processing time: 85 Days and 23.3 Hours
Abstract

We report a case of intermittent lower abdominal pain and distension accompanied by defecation difficulties for 3 years due to Chilaiditi syndrome in a 59-year-old male. Before admission to our hospital, the patient had undergone gastroscopy, which showed gastritis and duodenitis, and colonoscopy, which showed cecum deformation and cicatricial changes of the mucous membrane in the colon hepatic flexure. A computed tomography (CT) scan of the abdomen at our hospital confirmed right hepatic atrophy and interposition of the colon. Moreover, CT simulation endoscopy identified cystic dilatation in the colon hepatic flexure with the widest diameter of 8.2 cm. The patient was diagnosed with Chilaiditi syndrome. As the patient was unable to endure his defecation difficulties, he underwent a laparoscope-assisted right hemicolectomy. The patient had a good recovery. During the follow-up period of 9 mo, the patient remained symptom-free.

Keywords: Abdominal pain; Diagnosis; Management; Laparoscope-assisted right hemicolectomy; Chilaiditi sign; Chilaiditi syndrome; Case report

Core tip: We report a rare case of intermittent lower abdominal pain and distension accompanied by defecation difficulties due to Chilaiditi syndrome. The incidence of Chilaiditi syndrome is very low and is easily misdiagnosed. Imaging examination is an important diagnostic technique for Chilaiditi syndrome.