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Case of the Week 612


What is the most likely diagnosis?

  • 56 year-old with abdominal pain



Frontal Chest Radiograph

  1. Free-air in the abdomen
  2. Subphrenic abscess
  3. Subpulmonic effusion
  4. Situs inversus with dextrocardia
  5. Colonic interposition

Additional Image - Close-up

 

Additional Images

 

Close-up


Answer:

5. Colonic interposition

More (Click Discussion Tab)

 

 

Colonic Interposition between Diaphragm and Liver (Chilaiditi's Syndrome)

General Considerations

  • Pronounced “Ky-La-Ditty”
  • Refers to the usually asymptomatic interposition of the bowel (usually hepatic flexure of the colon) between the liver and the (right) hemidiaphragm
  • Seen in 0.1-0.25% of chest x-rays
  • Most frequently an incidental finding

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This Week

56 year-old with abdominal pain
 
 



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is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.