1977 Volume 27 Issue 3 Pages 199-205
The state of a part of the digestive tract, particularly colon, being incarcerated between the right diaphragm and liver is known as Chilaiditi syndrome today.
We have recently encountered five cases of this syndrome with different basal diseases, the details of which are reported here.
The cases were males aged 65 to 77 years; basal diseases consisted of acute hepatitis, congestive heart failure, ileus and cerebral arteriosclerotic Parkinsonism, while the remaining one case showed no definite basal disease. When symptomatic treatment using purgatives etc. was conducted in addition to the treatment of basal diseases, a gas pattern beneath the right diaphragm disappeared in three out of five cases.
As pathogenesis of this syndrome, Choussat and Choussat-Clausse mentioned three factors as follows.
(1) Intestinal factors.
(2) Diaphragmatic factors.
(3) Hepatic factors.
Subjective symptoms are composed mainly of constipation, sense of fullness of the abdomen, meteorism and abdominal pain but generally indefinite, and these symptoms appear to be influenced greatly by the severity of the basal disease.
This syndrome is not to be made light of since it sometimes posess a problem in differential diagnosis and since it could serve as a clue to the discovery of a basal disease.
