Lenz M, Kindler M, Schilling M, Pollack T, Schwab W, Becker M
Klinik für Allgemein- und Viszeralchirurgie, Weisseritztal-Kliniken GmbH, Freital, Deutschland.
Chirurg. 2011 Sep;82(9):828, 830-33. doi: 10.1007/s00104-011-2138-0.
We report on a case of an 80-year-old female patient who presented to the emergency room of with right upper quadrant abdominal pain since the day before. During the initial diagnostic an abdominal x-ray study revealed an air-filled colonic section of the bowel under the right hemidiaphragm corresponding to Chilaiditi's sign. The clinical symptoms and laboratory results were mild at this time. After 12 h the patient developed right upper quadrant peritonitis due to a perforated, subdiaphragmatic appendicitis based on Chilaiditi's syndrome. During surgical treatment the cecum and parts of the ascending colon were found to be interposed between the liver and right hemidiaphragm. A right hemicolectomy was performed which led to complete recovery of the patient. In addition to presenting this interesting case this article highlights the regime of the diagnostics and therapy of a complication of the very rare condition of Chilaiditi's syndrome.
我们报告一例80岁女性患者，该患者自前一日起出现右上腹腹痛，前往急诊室就诊。在初步诊断期间，腹部X光检查显示右半膈下有一段充满气体的结肠肠段，符合Chilaiditi征。此时临床症状和实验室检查结果较轻。12小时后，患者因基于Chilaiditi综合征的膈下阑尾穿孔而出现右上腹腹膜炎。手术治疗期间，发现盲肠和部分升结肠夹在肝脏和右半膈之间。实施了右半结肠切除术，患者得以完全康复。除了呈现这个有趣的病例外，本文还重点介绍了极为罕见的Chilaiditi综合征并发症的诊断和治疗方案。
