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
ARTICLE HIGHLIGHTS
Case characteristics

A 59-year-old male patient was admitted to our hospital due to intermittent lower abdominal pain and distension accompanied by defecation difficulties for 3 years.

Clinical diagnosis

Chilaiditi syndrome.

Differential diagnosis

Renal or biliary colic, sub-phrenic abscess, pneumoperitoneum or congenital diaphragmatic hernia.

Laboratory diagnosis

Computed tomography (CT) scan of the abdomen confirmed right hepatic atrophy and interposition of the colon. CT simulation endoscopy identified a cystic dilatation in the colon hepatic flexure with the widest diameter of approximately 8.2 cm.

Imaging diagnosis

Chilaiditi syndrome.

Treatment

The patient underwent laparoscope-assisted right hemicolectomy.

Related reports

The incidence of Chilaiditi syndrome is very low. Imaging examination is very important for differential diagnosis and can avoid unnecessary emergency operation. The main treatment is conservative treatment.

Term explanation

Chilaiditi sign refers to the abnormal interposition of the colon or small bowel between the liver and right diaphragm, Once Chilaiditi sign is associated with a variety of clinical respiratory and digestive symptoms, the name is designated as Chilaiditi syndrome.

Experiences and lessons

Chilaiditi syndrome is rare. Due to its low incidence, Chilaiditi syndrome is easily misdiagnosed. Imaging examination is an important diagnostic technique in Chilaiditi syndrome.