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Chilaiditi's Syndrome with sigmoid colon volvulus: case report

INTRODUCTION: This study aims at reporting a case of Chilaiditi Syndrome associated to sigmoid colon volvulus. CASE REPORT: Male patient, white, 51 years old, arrives at an emergency hospital in Pelotas with complaints of stoping the elimination of gases, diffuse abdominal pain, increase of abdominal volume, gradual and progressive inappetence, accepting only liquid. He is diagnosed with mental retardation and a situation of intestinal constipation. An acute abdomen Rx highlighted a diffuse colon distension, suggestive of sigmoid volvulus with tranversum colon image between the liver and the diaphragm. The patient was submitted to exploratory laparotomy being highlighted sigmoid volvulus, diffuse megacolon and interposition of the transverse colon between the liver and the diaphragm. Subtotal colectomy with terminal ascending colon colostomy was proceeded. The patient evolved satisfactorily being discharged on the 9th day. DISCUSSION: The interposition of the colon between the liver and the diaphragmatic cupula (Chilaiditi syndrome) associated to sigmoid colon volvulus constitutes a rare cause of obstructive acute abdomen, though the sigmoid volvulus is one of the main causes of mechanic intestinal obstruction in Brazil. Usually a clinical treatment is done, although when associated to complications the treatment is surgical.

Chilaiditi syndrome; volvulus; colon; Chilaiditi sign


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