Chilaiditi Sign and Syndrome as a Finding in the Emergency Room: A Case Report

The Chilaiditi sign is the presence of a loop of bowel interposed between the liver and the diaphragm. In most cases, the Chilaiditi sign is diagnosed as a rare incidental radiological finding on chest X-rays or the abdomen of asymptomatic patients. When associated with symptoms, it is named Chilaiditi syndrome. However, the symptoms are nonspecific, encompassing some of the most common causes of resorting to the emergency room (ER), such as abdominal pain, dyspnea, vomiting, or constipation, which hinders the differential diagnosis, so it's necessary to resort to imaging tests. We report a case of a 56-year-old male who presented to the ER due to dyspnea, constipation, and generalized abdominal pain/discomfort, with no other complaints. The chest X-ray revealed the presence of the Chilaiditi sign, and the diagnosis of Chilaiditi syndrome was considered as a diagnostic hypothesis and later confirmed with the computerized tomography (CT) scan and correlation of the patient's symptoms. We conclude that although Chilaiditi's syndrome is a rare condition, it should be considered as a possible differential diagnosis so that the patient receives adequate treatment with minimal harm since most cases are resolved with conservative treatment.