Published online May 9, 2021. doi: 10.5409/wjcp.v10.i3.40
Peer-review started: January 5, 2021
First decision: January 25, 2021
Revised: February 4, 2021
Accepted: March 10, 2021
Article in press: March 10, 2021
Published online: May 9, 2021
Chilaiditi syndrome is a rare disorder characterized by the hepatodiaphragmatic interposition of the intestine.
Here we report a case of a 12-year-old male who was admitted to the pediatric intensive care unit secondary to abdominal pain and severe respiratory distress. He was treated conservatively but the symptoms persisted requiring a surgical approach. While there have been several cases of Chilaiditi syndrome reported in adults, there is a scarcity of cases reported in the pediatric population. Our review of the literature found only 30 pediatric cases, including our reported case, with Chilaiditi syndrome, 19 (63%) of which were male. The median age of diagnosis was 4.5 years old with an interquartile range of 2.0-10.0 years. In our review, we found that the most common predisposing factors in children are aerophagia (12/30 cases) and constipation (13/30 cases). Ninety percent of the cases presented with complete intestinal interposition, in 100% of which, the colon was involved. Three of the 30 cases were associated with volvulus.
In the pediatric population, conservative (21/30 cases) and surgical (8/30 cases) treatment approaches have produced satisfactory outcomes for all the patients, regardless of approach.
Core Tip: We describe a pediatric case of Chilaiditi syndrome with successful treatment, as well as a literature review of all pediatric case reports of Chilaiditi syndrome. In the pediatric patients, both conservative and surgical approaches in treating Chilaiditi syndrome with treatment of predisposing factors have resulted in satisfactory outcomes.