A CASE OF CHILAIDITI SYNDROME PRESENTING WITH STRANGULATED ILEUS

Chilaiditi syndrome is a general term designating a condition that a part of the gastrointestinal tract incarcerates between the right diaphragm and liver. It is said that the syndrome has no particular symptoms and isoften detected accidentally. Recently we experienced a case of this disease, in which the ileum incarcerated beneath the right diaphragm, presenting with strangulated ileus. A 67-year-old man was referred to the hospital because of a right hypochondralgia by a nearby practitioner. Based on abdominal findings, abdominal X-ray examination, and CT, the patient was diagnosed as Chilaiditi syndrome associated with strangulated ileus. Emergency operation was performed. During the operation, a funicular material which was probably caused by previous hepatitis was found between the right lobe of the liver and peritoneum, and a part of the ileum incarcerated into the same region to be strangulated, accompanying by necrosis. Chilaiditi syndrome of the small intestine is a rare disease. Only 13 cases can be seen in the Japanese literature so far, 7 cases of which were associated with strangulated ileus. It is thought that Chilaiditi syndrome of the small intestine necessitates careful attention for possible association of strangulated ileus because of its frequent occurrence.