• M Lenz, M Kindler, M Schilling, T Pollack, W Schwab, and M Becker.
• Klinik für Allgemein- und Viszeralchirurgie, Weisseritztal-Kliniken GmbH, Freital, Deutschland. Matthias.Lenz@weisseritztal-kliniken.de
• Chirurg. 2011 Sep 1;82(9):828, 830-33.

AbstractWe report on a case of an 80-year-old female patient who presented to the emergency room of with right upper quadrant abdominal pain since the day before. During the initial diagnostic an abdominal x-ray study revealed an air-filled colonic section of the bowel under the right hemidiaphragm corresponding to Chilaiditi's sign. The clinical symptoms and laboratory results were mild at this time. After 12 h the patient developed right upper quadrant peritonitis due to a perforated, subdiaphragmatic appendicitis based on Chilaiditi's syndrome. During surgical treatment the cecum and parts of the ascending colon were found to be interposed between the liver and right hemidiaphragm. A right hemicolectomy was performed which led to complete recovery of the patient. In addition to presenting this interesting case this article highlights the regime of the diagnostics and therapy of a complication of the very rare condition of Chilaiditi's syndrome.

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