Rare. Interposition of the transverse colon between the diaphragm and the liver. Generally asymptomatic but sometimes causing abdominal pain, vomiting, constipation. It could be present on 0.1 % of all adult abdominal XRays.

Usually associated with cirrhosis of the liver with ascites, or dolichocolon or pulmonary emphysema. The differential diagnosis is with  an hernia and a diaphragmatic relaxation or a pneumoperitoneum.

Anesthetic implications:

according to the associated pathology (cirrhosis).

References : 

• Lohr CE, Nuss MA, McFadden DW, Hogg JP. 
  Laparoscopic management of Chilaiditi’s syndrome. 
  Surg Endoscopy 2004; 18:348
• Keles S, Artac H, Reisli I et al. 
  Chilaiditi syndrome as a cause of respiratory distress. 
  Eur J Pediatr 2006; 165: 367-9.

Updated: October 2019