Chilaiditi Sign: Beyond an Incidental Finding in Pediatrics A Case Report
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Abstract
Background: Chilaiditi’s sign is a radiological finding described as the presence of air secondary to the interposition of an intestinal segment between the liver and the right hemidiaphragm. It is usually documented as an incidental radiological finding and is usually an asymptomatic benign condition. Due to its radiological characteristics, it can confuse the clinician and lead to unnecessary diagnostic or therapeutic interventions. Some patients present with Chilaiditi syndrome, which is differentiated from the sign by the presence of nonspecific symptoms such as abdominal distension and pain, anorexia, nausea, and emesis.
Case summary: We present the case of a 3-month-old male infant with a history of ventricular septal defect under chronic management with anticongestive medication who presents respiratory symptoms due to the presence of acute bronchiolitis phenotype B due to Respiratory Syncytial Virus. During his hospitalization, he presented clinical deterioration, for which a chest X-ray was taken, which evidenced, as an incidental finding, superimposition of intestinal loops in the liver parenchyma, which pointed to the presence of the Chilaiditi sign, later confirmed in an abdominal X-ray. Its evolution courses without the presence of gastrointestinal symptoms.
Conclusion: Knowledge of the Chilaiditi Sign is of great importance for clinicians responsible for pediatric care, since its ignorance can lead to unnecessary diagnostic or therapeutic approaches; Likewise, the differentiation of this with the Chilaiditi syndrome is fundamental.
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References
(1) Kumar A, Mehta D. Chilaiditi syndrome [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. https: //www.ncbi.nlm.nih.gov/books/NBK554565
(2) Moaven O, Hodin RA. Chilaiditi syndrome: a rare entity with important differential diagnoses. Gastroenterol Hepatol (N Y). 2012;8(4):276-8.
(3) Venkataraman D, Harrison R, Warriner S. Abnormal gas pattern under diaphragm. BMJ Case Rep. 2012;2012:bcr0820114650. https://doi.org/10.1136/bcr.08.2011.4650 DOI: https://doi.org/10.1136/bcr.08.2011.4650
(4) Hussain S, Hussain S, Hussain S. Chilaiditi syndrome—what's air doing there? J Emerg Med. 2018;55(5): 131-2. https://doi.org/10.1016/j.jemermed.2018.07.022 DOI: https://doi.org/10.1016/j.jemermed.2018.07.022
(5) Evrengül H, Yüksel S, Orpak S, Özhan B, Ağladıoğlu K. Chilaiditi syndrome. J Pediatr. 2016;173: 26. https://doi.org/10.1016/j.jpeds.2016.02.060 DOI: https://doi.org/10.1016/j.jpeds.2016.02.060
(6) Sinopidis X, Gkentzi D, Kostopoulou E, Karatza A, Dimitriou G. Upgrade of Chilaiditi sign to syndrome: are there any predisposing factors? J Emerg Med. 2019;57(4): 573-4. DOI: https://doi.org/10.1016/j.jemermed.2019.04.035
(7) Rosa F, Pacelli F, Tortorelli AP, Papa V, Bossola M, Doglietto GB. Chilaiditi's syndrome. Surgery. 2011;150(1):133-134. https://doi.org/10.1016/j.surg.2009.11.023 DOI: https://doi.org/10.1016/j.surg.2009.11.023