Chilaiditi Syndrome: An Incidental Finding on a Chest Radiograph in a Long-Term Ventilated Patient

Background: Chilaiditi syndrome is a situation with a structural impingement of the colon on the liver, leading to an elevated hemidiaphragm in the X-ray along with a gas-like ap-pearance in the right hemithorax. It is generally a benign disease that is managed conservatively upon diagnosis. Rarely, it can be a cause of intestinal obstruction. Chilaiditi syndrome was origi-nally named after Demetrius Chilaiditi, the Greek radiologist who first described the case in 1910 while working in Vienna. Case Presentation: Here, we have described the case of a 76-year-old male who was admitted to our long-term care facility for chronic respiratory failure, and he was connected to mechanical ventilation via tracheostomy. He was having occasional bouts of constipation, and was on regular laxatives. In a CT chest film done because of very thick respiratory secretions and desaturation, an incidental finding of Chilaiditi syndrome was noted. : The patient has been managed conservatively with laxatives and per-need enemas. : Chilaiditi syndrome is a rare condition in which the colon interposes between the liver, right hemidiaphragm, and the abdominal wall, causing occasional clinical symptoms. Conversely, radiographic findings without clinical symptoms are known to exhibit the Chilaiditi sign. The disease's prevalence is estimated to be somewhere between 0.025 and 0.28%. Conclusion: Chilaiditi syndrome is a syndrome that refers to the interposition of the colon upon the hepatic flexure. It is a very rare but a serious cause of constipation, resulting in severe symptoms to the extent that they may warrant surgical intervention.