Chilaiditis syndrome

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Classification according to ICD-10
Q43.3 Congenital malformations that affect bowel fixation
ICD-10 online (WHO version 2019)

The Chilaiditis Syndrome or Chilaiditi Syndrome describes in medicine a displacement and rotation of the large and, less often, small intestine from further foot to head ( cranial ) between the diaphragm and liver . Usually there is no bowel in this area. The syndrome is an anatomical variant and not necessarily of disease value .

Surname

The term interpositio coli hepato-diaphragmatica ( Greek - Latin "displacement of the large intestine between the liver and diaphragm") is used synonymously . The syndrome was named after the Greek radiologist Dimítrios Chilaiditi , born in 1883, who lived in Vienna and Istanbul.

Occurrence

Chilaiditi syndrome on axial computed tomography
Chilaiditi syndrome on sagittal computed tomography

The syndrome is rather rare (less than 1%) and is usually recognized as an incidental finding on x-rays of the lungs , on a computed tomogram of the upper abdomen or on abdominal ultrasound . Knowledge of this anatomical variant is of great importance for interventions on the liver, especially liver punctures .

Anatomy / pathophysiology

Parts of the large intestine - especially its right upper bend (the flexure ) - or, more rarely, the small intestine, are shifted between the right lobe of the liver and the right diaphragm. The syndrome can be associated with malformations of the liver, diaphragm, or large intestine.

A twist (a torsion) of the right bow of the large intestine around the longitudinal axis of the mesentery supplying the intestine with blood (the mesocolon for the large or the mesentery for the small intestine) can cause dangerous, rhythmic occlusion of the intestine due to the digestive movements of the intestine ( peristalsis ) or its blood supply.

complaints

Usually the patients are symptom-free . But it can also build up in front of the interposed large intestine, which can cause flatulence and pain up to a life-threatening intestinal obstruction (an ileus ) (see above).

literature

  • D. Chilaiditi: On the question of hepatoptosis and ptosis in general following three cases of temporary, partial liver displacement. In: Advances in the field of X-rays. 1910, 16, pp. 173-208.
  • Keith A. Havenstrite, James A. Harris, David E. Rivera: Splenic Flexure Volvulus in Association with Chilaiditi Syndrome: Report of a Case. In: Southeastern Surgical Congress, Fort Gordon , Georgia , September 1999, 65 (9), p. 874.
  • M. Sato, H. Ishida, K. Konno, Y. Hamashima, H. Naganuma, T. Komatsuda, J. Ishida, S. Watanabe: Chilaiditi syndrome: sonographic findings. In: Abdominal Imaging . New York 2000, 25 (4), pp. 397-399.

Web links

Illustrations

Individual evidence

  1. ↑ a b Pschyrembel Clinical Dictionary Version 2002 (electronic version of the 258th edition).