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奇莱迪蒂氏征:一例同时患有肝硬化和慢性淋巴细胞白血病患者的罕见发现。

Chilaiditi's Sign: A Rare Finding in a Patient with Concurrent Liver Cirrhosis and Chronic Lymphocytic Leukemia.

作者信息

Adjei Prosper, Asamoah Prince Henry, Ohene Dominic Asante, Amoakohene-Yeboah Augustina, Asasu Stanley Anenyemele

机构信息

Department of Internal Medicine, Methodist Hospital, Wenchi, Ghana.

出版信息

Clin Med Insights Case Rep. 2024 Sep 10;17:11795476241278973. doi: 10.1177/11795476241278973. eCollection 2024.

Abstract

Chilaiditi's sign is a rare radiological finding characterized by colonic interposition between the liver and the right hemidiaphragm. It is a cause of pseudopneumoperitoneum which is often mistaken for true pneumoperitoneum. In this article, we present the case of a 73-year-old female with a previous history of pulmonary tuberculosis, who reported to our hospital with progressive abdominal distension associated with early satiety, bipedal swelling, generalized weakness, worsening fatigue, and weight loss. Following evaluation, she was diagnosed with liver cirrhosis and chronic lymphocytic leukemia. Her chest radiograph also incidentally showed air under the right hemidiaphragm with haustral folds consistent with Chilaiditi's sign. Since she did not have signs of peritonitis, she was eventually treated for liver cirrhosis and chronic lymphocytic leukemia without undergoing any surgical intervention. This case report seeks to create awareness among clinicians about this rare radiological sign in order to prevent misdiagnosis leading to unnecessary surgical procedures.

摘要

奇莱迪蒂氏征是一种罕见的影像学表现,其特征为结肠位于肝脏与右半膈之间。它是假性气腹的一个原因,常被误诊为真性气腹。在本文中,我们报告了一例73岁女性病例,该患者既往有肺结核病史,因进行性腹胀伴早饱、双下肢肿胀、全身乏力、疲劳加重及体重减轻前来我院就诊。经评估,她被诊断为肝硬化和慢性淋巴细胞白血病。她的胸部X线片还偶然显示右半膈下有气体,伴有结肠袋状皱襞,符合奇莱迪蒂氏征。由于她没有腹膜炎体征,最终未接受任何手术干预,而是接受了肝硬化和慢性淋巴细胞白血病的治疗。本病例报告旨在提高临床医生对这种罕见影像学征象的认识,以防止误诊导致不必要的手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f41a/11406644/6453de2899cf/10.1177_11795476241278973-fig1.jpg

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