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Canadian Journal of Gastroenterology and Hepatology
Volume 2016, Article ID 2174704, 2 pages
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Colonic Interposition between the Liver and Diaphragm: “The Chilaiditi Sign”

Department of Medicine, Bronx-Lebanon Hospital Center, 1650 Selwyn Avenue, Suite No. 10C, Bronx, NY 10457, USA

Received 28 September 2015; Accepted 4 October 2015

Copyright © 2016 Nita Nair et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A 90-year-old wheelchair bound male was brought to the emergency department with complaints of worsening abdominal pain over the last 2-3 days. The patient also had difficulty in passing urine. Abdominal examination revealed tenderness in the umbilical and hypogastric area without rebound tenderness or guarding. Computed tomography (CT) of the abdomen showed a loop of colon interpositioned between the liver and the right hemidiaphragm (the Chilaiditi sign), mimicking free air. Foley’s catheter was placed and the patient was managed conservatively. The patient clinically improved with improvement of the abdominal pain.