Tariq Hassan Ali, Pillay Tharuneshan
Prince Mshiyeni Memorial Hospital, Department of Surgery, Durban, South Africa.
Afr J Emerg Med. 2020 Dec;10(4):266-268. doi: 10.1016/j.afjem.2020.04.001. Epub 2020 May 25.
Chilaiditi's sign is the presence of radiolucency in the subdiaphragmatic space as a result of colonic interposition, often misdiagnosed as a pneumoperitoneum. It is caused by anatomical variations that result in transpositioning of bowel within the subdiaphragmatic space. Chilaiditi's syndrome is the presentation of cardiac, respiratory or abdominal symptoms accompanied by Chilaiditi's sign. Symptomatic patients are managed with surgical intervention with the literature suggesting various resective and non-resective techniques to correct the anatomical defect. In this case an open right hemicolectomy was performed in attempt to remove the transpositioning bowel and a hepatopexy was performed to prevent any further reoccurrence of the syndrome. This case report highlights the diagnostic dilemma and management of Chilaiditi's syndrome in a resource constrained Sub-Saharan Hospital.
奇莱迪蒂氏征是指由于结肠插入导致膈下间隙出现透亮区，常被误诊为气腹。它是由解剖变异引起的，导致肠道在膈下间隙移位。奇莱迪蒂氏综合征是指伴有奇莱迪蒂氏征的心脏、呼吸或腹部症状。有症状的患者通过手术干预进行治疗，文献中提出了各种切除性和非切除性技术来纠正解剖缺陷。在本病例中，进行了开放性右半结肠切除术以试图移除移位的肠道，并进行了肝脏固定术以防止该综合征再次发生。本病例报告强调了撒哈拉以南地区资源有限的医院中奇莱迪蒂氏综合征的诊断困境和治疗方法。
