Images in Clinical Medicine
Hepatodiaphragmatic Interposition of the Colon
N Engl J Med 2000; 343:631August 31, 2000
- Article
Figure 1 A 30-year-old man with a mild respiratory tract infection reported having had intermittent abdominal bloating for more than 15 years. He had no other symptoms, he took no medications, and his family history was unremarkable. On examination, his abdomen was slightly distended but not tender, and there was no dullness to percussion over the right upper quadrant. Laboratory studies were unremarkable, except for the finding of a benign monoclonal gammopathy. A posteroanterior chest film (Panel A) and a lateral chest film (Panel B) showed that the right hemidiaphragm was elevated and that the transverse colon was interposed between the liver and the diaphragm. This anatomical abnormality is known as Chilaiditi's syndrome. The patient was treated conservatively without surgery.
Jun Nakagawa, M.D., Ph.D.
Nakagawa Naika Clinic, Kyoto 610-1146, Japan
